Adventist Health Clear Lake

LBN: Adventist Health Clearlake Hospital Inc.
Adventist Health Clear Lake is an health care organization with primary practice located at 5290 State St , Kelseyville CA 95451-9450. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Adventist Health Clearlake Hospital Inc. can be contacted via phone (707) 279-8813, or through Howe, Judson H.E. via phone (707) 456-3010.

Contact Information

Primary practice address
5290 State St Kelseyville CA 95451-9450
Fax: (707) 279-2241
Website:
Authorized official contact:
Name: Howe, Judson H.E.

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X 110000174 California

Profile Details

NPI number 1962492876
LBN Legal business name Adventist Health Clearlake Hospital Inc.
DBA Doing business as Adventist Health Clear Lake
Authorized official Howe, Judson H.E.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2005
Last updated May 29th, 2024 - about 7 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962492876 NPPES
California Other ZZZ49286Z BLUE SHIELD
California MEDICAID RHM19999G BLUE SHIELD

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