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6550 Front Street Forestville CA 95436-0000 | |
(707) 887-0290 | |
(707) 887-2790 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 6550 Front Street, Forestville, California |
Authorized Official Name and Position | Mary E Szecsey (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7078691594 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1449 Guerneville CA 95446-1449 Ph: (707) 869-5977 | 6550 Front Street Forestville CA 95436-0000 Ph: (707) 887-0290 |
NPI Number | 1659630036 |
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Provider Enumeration Date | 05/07/2012 |
Last Update Date | 05/07/2012 |
Identifier | Type | State | Issuer |
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1659630036 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |