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General NPI Number Information
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NPI Number | 1689742215
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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 | 12/01/2006
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 684 BENECIA DRIVE
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City | SANTA ROSA
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State | CA
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Zip | 95409-3058
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Country | US
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Telephone | 707-573-4565
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Fax | 707-576-6687
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Provider Business Mailing Address
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Address Line | 3569 ROUND BARN CIRCLE
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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 | CHIEF EXECUTIVE OFFICER
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Name | MS. 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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 070000491
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License Number State | CA
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