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Organization
NORTHEAST VALLEY HEALTH CORPORATION
Active
Organization
NORTHEAST VALLEY HEALTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY WYARD (CHIEF EXECUTIVE OFFICER)
(818) 898-1388
Entity
Organization
Contact information
Practice address
26974 RAINBOW GLEN DR, SANTA CLARITA, CA 91351-4875
(661) 673-8888
(661) 298-8668
Mailing address
1172 N MACLAY AVE, SAN FERNANDO, CA 91340-1328
(818) 898-1388
(818) 365-4031
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
09/28/2012
Last updated
02/23/2022
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