| Organization Name: | ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC-MIDDLETOWN FAMILY HEALTH CENT |
| NPI Number: | 1124204821 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENNIFER L. SWENSON (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 18th Ave And Highway 53 Clearlake |
| State: | CA US |
| Postal Code: | 954226710 |
| Phone Number: | 7079873311 |
| Fax Number: | 7079872455 |
| NPI Enumeration Date: | 01/14/2008 |
| NPI Last Update Date: | 01/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 110000174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |