institution
Susanville Indian Rancheria
Federally Qualified Health Center (FQHC) in Susanville, California
NPI 1770564049

Susanville Indian Rancheria is a Federally Qualified Health Center (FQHC) based in Susanville, CA and is specialized in Federally Qualified Health Center (FQHC). Susanville Indian Rancheria practices in Susanville, CA. The NPI Number for Susanville Indian Rancheria is 1770564049 and holds a License No. 230000120 (California).

The current practice location address for Susanville Indian Rancheria is 795 Joaquin St, Susanville, CA and can be reached out via phone at 530-257-2542 and via fax at 530-251-5208.

Location: 795 Joaquin St, Susanville, CA, 96130-3628
institution
Provider Profile Details
NPI Number
1770564049
Provider Name
Susanville Indian Rancheria
Credential
Provider Entity Type
Organization
Address
795 Joaquin St, Susanville, CA, 96130-3628
Phone Number
530-257-2542
Fax Number
530-251-5208
Provider Enumeration Date
11/14/2005
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
PHA470460 05 CA
THP03876F 05 CA
institution
Provider Business Practice Location Address Details
Address
795 Joaquin St
City
State
Zip
96130-3628
Phone Number
530-257-2542
Fax Number
530-251-5208
person
Provider Business Mailing Address Details
Address
795 Joaquin St
City
State
Zip
96130-3628
Phone Number
530-257-2542
Fax Number
530-251-5208
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
230000120 (California)
Definition
Definition to come...
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