| Organization Name: | BORREGO COMMUNITY HEATH FOUNDATION |
| NPI Number: | 1962830174 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL DOUGLAS DEW (DIRECTOR OR MANAGED CARE OPERATIONS) |
| Mailing Address: | 29490 Lakeview Ave Nuevo |
| State: | CA US |
| Postal Code: | 925679705 |
| Phone Number: | 9519282805 |
| Fax Number: | 9519282842 |
| NPI Enumeration Date: | 10/24/2013 |
| NPI Last Update Date: | 11/18/2013 |
| 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: | |