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Organization

GREENVILLE RANCHERIA

Active
Other names
Greenville Rancheria Tribal Health
Organization subpart
No

Provider details

NPI number
Authorized official
PATTY ALLEN (FISCAL OFFICER)
(530) 284-7990
Entity
Organization

Contact information

Practice address
410 MAIN STREET, GREENVILLE, CA 95947-0279
(530) 284-6135
(530) 284-7594
Mailing address
PO BOX 279, GREENVILLE, CA 95947-0279
(530) 284-7990
(530) 284-7299

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
THP70390G
CA
Enumeration date
08/30/2005
Last updated
03/12/2009
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