| NPI | 1649547944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LOHR Chief Executive Officer 909-382-7190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: CA CMM70744F) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2022-09-01 |