Organization
SANTA ROSA COMMUNITY HEALTH CENTERS
Active
Other names
Southwest Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD BROCKMAN (CFO)
(707) 583-8839
Entity
Organization
Contact information
Practice address
599 BELLEVUE AVE, SANTA ROSA, CA 95407-7713
(707) 547-2220
(707) 303-3182
Mailing address
599 BELLEVUE AVE, SANTA ROSA, CA 95407-7713
(707) 547-2220
(707) 303-3182
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
110000489
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HAP70937F
FAMILY PACT ID
CA
Enumeration date
06/11/2007
Last updated
11/15/2012
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