Organization Name: | BORREGO COMMUNITY HEALTH FOUNDATION |
NPI Number: | 1407288061 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRUCE HEBETS (CEO) |
Mailing Address: | 66675 Pierson Blvd Desert Hot Springs |
State: | CA US |
Postal Code: | 922403737 |
Phone Number: | 7606765240 |
Fax Number: | 7602510541 |
NPI Enumeration Date: | 08/06/2013 |
NPI Last Update Date: | 08/06/2013 |
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: |