Organization Name: | LIVINGSTON COMMUNITY HEALTH |
NPI Number: | 1295184117 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LESLIE TAMIKO MCGOWAN (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 1010 W Las Palmas Ave Ste E Patterson |
State: | CA US |
Postal Code: | 953638873 |
Phone Number: | 2093947913 |
Fax Number: | 2093949093 |
NPI Enumeration Date: | 06/10/2016 |
NPI Last Update Date: | 06/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |