| NPI | 1508487653 |
|---|---|
| Doing Business As | SACRAMENTO COMMUNITY CLINIC - 55TH |
| Entity Type | Organization |
| Authorized Contact | JERRY T BLIATOUT CEO 916-642-1867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251B00000X Case Management |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2023-05-31 |