| NPI | 1679013726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY WEBER CEO 209-384-6493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2017-03-10 |