Basic Information
| Provider Information | |||||||||
| NPI: | 1851385918 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ONE COMMUNITY HEALTH | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LA CLINICA DEL CARINO FAMILY HEALTH CARE CENTER, INC. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 849 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | HOOD RIVER | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970311956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413866380 | ||||||||
| FaxNumber: | 5413861078 | ||||||||
| Practice Location | |||||||||
| Address1: | 849 PACIFIC AVE. | ||||||||
| Address2: | |||||||||
| City: | HOOD RIVER | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970311956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413866380 | ||||||||
| FaxNumber: | 5413861078 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2005 | ||||||||
| LastUpdateDate: | 12/31/2015 | ||||||||
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| AuthorizedOfficialLastName: | BATCHA | ||||||||
| AuthorizedOfficialFirstName: | BELINDA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5413088363 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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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.