| Organization Name: | ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC |
| NPI Number: | 1841626587 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JONI A MCALLISTER (NORTHERN CALIF NETWORK PFS MANAGER) |
| Mailing Address: | 9430 Lake St Lower Lake |
| State: | CA US |
| Postal Code: | 954578600 |
| Phone Number: | 7075712819 |
| Fax Number: | 7075712970 |
| NPI Enumeration Date: | 09/25/2013 |
| NPI Last Update Date: | 09/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 110000174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |