Organization
HEALTH AND LIFE ORGANIZATION, INC.
Active
Organization
HEALTH AND LIFE ORGANIZATION, INC.
Active
Other names
Sacramento Community Clinic - 55th
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY T BLIATOUT (CEO)
(916) 642-1867
Entity
Organization
Contact information
Practice address
7215 55TH ST, SACRAMENTO, CA 95823-2659
(916) 642-1867
(884) 491-6066
Mailing address
3030 EXPLORER DR, SACRAMENTO, CA 95827-2728
(916) 642-1867
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
05/31/2023
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