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General NPI Number Information
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NPI Number | 1598768962
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Entity Type | Organization
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Legal Business Name | WEST COUNTY HEALTH CENTERS, INC.
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 3802 MAIN STREET
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City | OCCIDENTAL
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State | CA
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Zip | 95464
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Country | US
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Telephone | 707-874-2444
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Fax | 707-874-1664
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Provider Business Mailing Address
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Address Line | PO BOX 1449
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City | GUERNEVILLE
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State | CA
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Zip | 95446-1449
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Country | US
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Telephone | 707-874-2444
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Fax | 707-874-1664
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | MISS TARI M WALLACE
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Credential |
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Telephone | 707-869-5977
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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 | CA
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