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Organization
WELLSPACE HEALTH
Active
Organization
WELLSPACE HEALTH
Active
Other names
WellSpace Health THRIVE Outpatient Program
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALASDAIR JONATHAN PORTEUS PHD (CHIEF EXECUTIVE OFFICER)
(916) 550-5444
Entity
Organization
Contact information
Practice address
2435 MARCONI AVE, SACRAMENTO, CA 95821-4807
(916) 313-8420
Mailing address
1500 EXPO PKWY, SACRAMENTO, CA 95815-4227
(916) 469-4690
(916) 880-5552
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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