| Organization Name: | WEST COUNTY HEALTH CENTERS, INC. |
| NPI Number: | 1356344758 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TARI M WALLACE (BILLING DIRECTOR) |
| Mailing Address: | 16319 Third Street Guerneville |
| State: | CA US |
| Postal Code: | 95446 |
| Phone Number: | 7078692849 |
| Fax Number: | 7078691477 |
| NPI Enumeration Date: | 05/31/2005 |
| NPI Last Update Date: | 01/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | XXXXXXX |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |