Organization
MENDOCINO COAST CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCRESHA M RENTERIA (EXECUTIVE DIRECTOR)
(707) 964-1251
Entity
Organization
Contact information
Practice address
510 CYPRESS ST STE C-100, FORT BRAGG, CA 95437-5411
(707) 961-3430
Mailing address
510 CYPRESS ST STE C-100, FORT BRAGG, CA 95437-5411
(707) 961-3430
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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