| Organization Name: | SURPRISE VALLEY HEALTH CARE DISTRICT |
| NPI Number: | 1073693651 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WANDA L GROVE (ADMINISTRATOR) |
| Mailing Address: | 745 Main Street Cedarville |
| State: | CA US |
| Postal Code: | 96104 |
| Phone Number: | 5302796111 |
| Fax Number: | 5302792680 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 09/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 230000025 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |