| Southern Trinity Health Inc | |
|
153-a Van Duzen Rd Mad River CA 95552 | |
| (707) 574-6616 | |
| (707) 574-6523 |
| Full Name | Southern Trinity Health Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 153-a Van Duzen Rd, Mad River, California |
| Authorized Official Name and Position | Graylan Lupton (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7075746616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Trinity Health Inc Po Box 7 Scotia CA 95565-0007 Ph: (707) 764-5617 | Southern Trinity Health Inc 153-a Van Duzen Rd Mad River CA 95552 Ph: (707) 574-6616 |
| NPI Number | 1316121007 |
|---|---|
| Provider Enumeration Date | 12/18/2007 |
| Last Update Date | 04/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316121007 | NPI | - | NPPES |
| EAP70040F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Southern Trinity Health Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 153-a Van Duzen Rd, Mad River, CA 95552 Phone: 707-574-6616 Fax: 707-574-6523 | |
The Wecare Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 321 Van Duzen Road, Mad River, CA 95552 Phone: 707-574-6616 Fax: 707-574-6523 |