Organization
POTTER VALLEY COMMUNITY HEALTH CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL N CARTER (EX DIRECTOR)
(707) 743-1188
Entity
Organization
Contact information
Practice address
10175 MAIN ST, POTTER VALLEY, CA 95469-9749
(707) 743-1188
(707) 743-1192
Mailing address
PO BOX 238, POTTER VALLEY, CA 95469-0238
(707) 743-1188
(707) 743-1192
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
FHC03879F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC03879F
—
CA
Enumeration date
09/27/2005
Last updated
08/22/2020
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