Organization
OLE HEALTH
Active
Other names
Davis Community Clinic, CommuniCare OLE
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE MACISAAC (CFO)
(760) 767-6435
Entity
Organization
Contact information
Practice address
2051 JOHN JONES RD, DAVIS, CA 95616-9701
(530) 758-2060
(530) 758-8490
Mailing address
PO BOX 1260, DAVIS, CA 95617
(530) 753-3498
(530) 758-2109
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
03000146
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC11771F
—
CA
Enumeration date
06/14/2005
Last updated
10/17/2023
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