Organization
ELICA HEALTH CENTERS
Active
Organization
ELICA HEALTH CENTERS
Active
Parent organization
ELICA HEALTH CENTERS
Other names
Elica Health Centers - Cadillac Drive
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELICA HEALTH CENTERS
Authorized official
TATYANA BAK (CEO)
(916) 569-8484
Entity
Organization
Contact information
Practice address
77 CADILLAC DR STE 200, SACRAMENTO, CA 95825-8337
(916) 454-2345
(916) 890-3828
Mailing address
1860 HOWE AVE STE 440, SACRAMENTO, CA 95825-1098
(916) 569-8484
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/26/2020
Last updated
03/08/2022
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