Organization
MOUNTAIN VALLEYS HEALTH CENTERS
Active
Other names
Mount Shasta Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON WATKINS (CFO)
(530) 999-9010
Entity
Organization
Contact information
Practice address
101 OLD MCCLOUD RD, MOUNT SHASTA, CA 96067-2796
(530) 999-9040
Mailing address
PO BOX 277, BIEBER, CA 96009-0277
(530) 999-9010
(530) 294-5392
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629570320
—
CA
Enumeration date
03/08/2018
Last updated
07/28/2023
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