| Mountain Health & Community Services, Inc. | |
|
316 25th St San Diego CA 92102-3016 | |
| (619) 238-5551 | |
| (619) 238-3807 |
| Full Name | Mountain Health & Community Services, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 316 25th St, San Diego, California |
| Authorized Official Name and Position | Judith Shaplin (CEO) |
| Authorized Official Contact | 6194456200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Health & Community Services, Inc. 31115 Highway 94 Campo CA 91906-3133 Ph: (619) 478-5254 | Mountain Health & Community Services, Inc. 316 25th St San Diego CA 92102-3016 Ph: (619) 238-5551 |
| NPI Number | 1861603151 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 05/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861603151 | NPI | - | NPPES |
| BCP71185F | Other | CA | STATE PROGRAM |
| FHC71185F | Medicaid | CA | |
| HAP71185F | Other | CA | STATE PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550000543 (California) | Primary |
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