| Mountain Health & Community Services, Inc. | |
|
1620 Alpine Blvd Ste 110 Alpine CA 91901-1103 | |
| (619) 445-6200 | |
| (619) 320-3343 |
| Full Name | Mountain Health & Community Services, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1620 Alpine Blvd Ste 110, Alpine, 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. 1620 Alpine Blvd Ste 110 Alpine CA 91901-1103 Ph: (619) 445-6200 |
| NPI Number | 1255499075 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 05/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255499075 | NPI | - | NPPES |
| FHC71082F | Medicaid | CA | |
| BCP71082F | Other | CA | STATE PROGRAM |
| HAP71082F | Other | CA | STATE PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000681 (California) | Primary |
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