NPI | 1821357492 |
---|---|
Entity Type | Organization |
Authorized Contact | ALASDAIR JONATHAN PORTEUS Chief Executive Officer 916-737-5555 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2012-05-16 |
Last Update Date | 2024-03-20 |