Colusa Indian Community Council
Clinic/Center, Federally Qualified Health Center (FQHC) in Colusa, CA. Organization (NPI-2).
NPI number1790778660
StatusActive
Last updated in NPPESJun 16, 2018
Details
- NPI
- 1790778660
- Entity type
- Organization (NPI-2)
- Legal business name
- Colusa Indian Community Council
- Organization subpart
- Yes
- Enumeration date
- Aug 25, 2005
- Last updated
- Jun 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | CA | Yes |
Other names
- Colusa Indian Community Council (Other Name)
- Colusa Indian Health Clinic (Doing Business As)
Practice location
3710 Highway 45Colusa, CA 95932
Phone 530-458-5501 · Fax 530-458-8660
Mailing address
3710 Highway 45Colusa, CA 95932
Phone 530-458-5501 · Fax 530-458-8660
Authorized official
Catrina Marie Ross
Director Of Clinic Operations
5304586542
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