Organization
MOUNTAIN HEALTH & COMMUNITY SERVICES, INC.
Active
Other names
Mountain Empire School Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH SHAPLIN (CEO)
(619) 445-6200
Entity
Organization
Contact information
Practice address
3291 BUCKMAN SPRINGS RD, PINE VALLEY, CA 91962-4003
(619) 473-8601
(619) 478-2267
Mailing address
31115 HIGHWAY 94, CAMPO, CA 91906-3133
(619) 478-5254
(619) 478-9164
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
090000135
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP03814F
STATE PROGRAM
CA
05
—
FHC03814F
—
CA
01
—
HAP03814F
STATE PROGRAM
CA
Enumeration date
11/16/2007
Last updated
05/08/2017
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