| NPI | 1528508488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ALEXANDER Executive Director 209-754-6258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| 152W00000X Optometrist | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2025-06-12 |