Russian River Health Center Building #2

LBN: West County Health Centers, Inc.
Russian River Health Center Building #2 is an health care organization with primary practice located at 16312 Third Street , Guerneville CA 95446. 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. West County Health Centers, Inc. can be contacted via phone (707) 869-2933, or through Wallace, Tari M via phone (707) 869-5977.

Contact Information

Primary practice address
16312 Third Street Guerneville CA 95446
Phone: (707) 869-2933
Fax: (707) 869-2663
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Tari M
Phone: (707) 869-5977

Health care specialties

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

Profile Details

NPI number 1598786352
LBN Legal business name West County Health Centers, Inc.
DBA Doing business as Russian River Health Center Building #2
Authorized official Wallace, Tari M
Entity Organization
Organization subpart 1 No
Enumeration date Jul 21st, 2006
Last updated Feb 28th, 2008 - about 17 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 1598786352 NPPES
California MEDICAID FHC70957F

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