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General NPI Number Information
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NPI Number | 1255600037
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Entity Type | Organization
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Legal Business Name | SANTA ROSA COMMUNITY HEALTH CENTERS
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Dates
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Enumeration Date | 12/22/2011
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Last Update Date | 12/22/2011
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Provider Practice Location Address
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Address Line | 3569 ROUND BARN CIR
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City | SANTA ROSA
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State | CA
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Zip | 95403-5781
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Country | US
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Telephone | 707-303-3600
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Fax | 707-303-3635
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Provider Business Mailing Address
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Address Line | 3569 ROUND BARN CIR
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City | SANTA ROSA
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State | CA
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Zip | 95403-5781
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Country | US
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Telephone | 707-303-3600
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Fax | 707-303-3635
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Authorized Official
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Title or Position | CEO
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Name | NAOMI FUCHS
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Credential |
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Telephone | 707-303-3091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 110000300
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License Number State | CA
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