Basic Information
| Provider Information | |||||||||
| NPI: | 1215561808 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMMUNICARE HEALTH CENTERS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1260 | ||||||||
| Address2: | |||||||||
| City: | DAVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956171260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307533498 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1717 5TH ST | ||||||||
| Address2: | |||||||||
| City: | DAVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956163945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307580354 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2020 | ||||||||
| LastUpdateDate: | 02/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | APICELLA | ||||||||
| AuthorizedOfficialFirstName: | CAROLINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5307531206 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.