Organization
MENDOCINO COAST CLINICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCRESHA M RENTERIA (CEO)
(707) 964-1251
Entity
Organization
Contact information
Practice address
690 S MAIN ST, FORT BRAGG, CA 95437-5108
(707) 364-1251
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 364-1251
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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