Organization
ADVENTIST HEALTH MENDOCINO COAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUNICE WILSON (DIRECTOR)
(707) 961-4651
Entity
Organization
Contact information
Practice address
700 RIVER DR, FORT BRAGG, CA 95437-5403
(707) 961-4651
Mailing address
PO BOX 841941, LOS ANGELES, CA 90084-1941
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
010000146
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA07746F
—
CA
Enumeration date
05/24/2006
Last updated
09/18/2025
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