| NPI | 1841916889 |
|---|---|
| Doing Business As | GRAVENSTEIN SOUTH |
| Entity Type | Organization |
| Authorized Contact | VIKKI MINNIFIELD Billing Manager 707-271-7052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2022-10-12 |