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Organization

ANTELOPE VALLEY COMMUNITY CLINIC

Active
Other names
Lancaster Adult Day Health Care
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TERESA ROA (FINANCE SPECIALIST)
(661) 942-2391
Entity
Organization

Contact information

Practice address
45104 10TH ST W, LANCASTER, CA 93534-2310
(661) 942-2391
(661) 902-6839
Mailing address
45104 10TH ST W, LANCASTER, CA 93534-2310
(661) 942-2391
(661) 902-6839

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550001452
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1730499872
CA
Enumeration date
03/02/2016
Last updated
03/02/2016
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