Organization
LONG VALLEY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY O GRAINGER (EXECUTIVE DIRECTOR)
(707) 984-6131
Entity
Organization
Contact information
Practice address
50 BRANSCOMB ROAD, LAYTONVILLE, CA 95454
(707) 984-6131
(707) 984-6990
Mailing address
PO BOX 870, LAYTONVILLE, CA 95454-0870
(707) 984-6131
(707) 984-6990
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70034F
—
CA
01
—
ZZZ84629Z
NHIC
—
Enumeration date
07/12/2006
Last updated
11/07/2013
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