| NPI | 1609594431 |
|---|---|
| Doing Business As | GRASSROOTS DPC |
| Entity Type | Organization |
| Authorized Contact | JERRY MICHAEL CLINE Physician 707-887-3651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 261QA0005X Clinic/Center, Ambulatory Family Planning Facility | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM1000X Clinic/Center, Migrant Health | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2025-06-20 |