| NPI | 1649005737 |
|---|---|
| Doing Business As | WELLSPACE HEALTH THRIVE OUTPATIENT PROGRAM |
| Entity Type | Organization |
| Authorized Contact | ALASDAIR JONATHAN PORTEUS Chief Executive Officer 916-550-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 104100000X Social Worker |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2024-09-06 |
| Last Update Date | 2024-09-06 |