| 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 |