Grass Valley Clinic

LBN: Chapa-De Indian Health Program, Inc.
Grass Valley Clinic is an health care organization with primary practice located at 1350 E Main St , Grass Valley CA 95945-5208. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Chapa-De Indian Health Program, Inc. can be contacted via phone (530) 477-8545, or through Haitsma, Sierk via phone (530) 887-2841.

Contact Information

Primary practice address
1350 E Main St Grass Valley CA 95945-5208
Phone: (530) 477-8545
Fax: (530) 477-9217
Website:
Map and Directions
Authorized official contact:
Name: Haitsma, Sierk
Phone: (530) 887-2841

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 230000303 California

Profile Details

NPI number 1922138841
LBN Legal business name Chapa-De Indian Health Program, Inc.
DBA Doing business as Grass Valley Clinic
Authorized official Haitsma, Sierk
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2007
Last updated Nov 2nd, 2011 - about 14 years 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 1922138841 NPPES
California MEDICAID THP80244F

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