Organization
MENDOCINO COAST CLINICS, INC
Active
Parent organization
MENDOCINO COAST CLINICS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MENDOCINO COAST CLINICS, INC
Authorized official
LUCRESHIA RENTERIA (AUTHORIZED OFFICIAL)
(707) 964-1251
Entity
Organization
Contact information
Practice address
510 CYPRESS ST STE D, FORT BRAGG, CA 95437
(707) 964-5696
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2653
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/08/2011
Last updated
10/28/2019
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