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General NPI Number Information
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NPI Number | 1326974643
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Entity Type | Organization
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Legal Business Name | TRI-STATE COMMUNITY HEALTHCARE CENTER
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 31739 RIVERSIDE DR STE A
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-7818
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Country | US
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Telephone | 951-245-0505
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Fax | 951-245-0999
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Provider Business Mailing Address
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Address Line | 1535 E COLORADO ST
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City | GLENDALE
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State | CA
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Zip | 91205-1513
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Country | US
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Telephone | 747-221-3530
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ARAM MANOUKIAN
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Credential |
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Telephone | 760-326-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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