Organization
GREENVILLE RANCHERIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIA LOUISE HAYWORTH (BILLING SUPERVISOR)
(530) 528-8600
Entity
Organization
Contact information
Practice address
13545 SAINT MARYS AVE, RED BLUFF, CA 96080-8884
(530) 528-8600
(530) 528-8612
Mailing address
PO BOX 279, GREENVILLE, CA 95947-0279
(530) 528-3481
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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