| Organization Name: | LBA |
| NPI Number: | 1205001682 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMY ZACHARY-PENTON (ADMINISTRATOR) |
| Mailing Address: | 148 E Kings St Avenal |
| State: | CA US |
| Postal Code: | 932041529 |
| Phone Number: | 5593869000 |
| Fax Number: | 5593869090 |
| NPI Enumeration Date: | 04/25/2008 |
| NPI Last Update Date: | 06/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 207RN0300X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |