Organization
ELICA HEALTH CENTERS
Active
Organization
ELICA HEALTH CENTERS
Active
Other names
Elica Health Centers - Health On Wheels
Organization subpart
No
Provider details
NPI number
Authorized official
TATYANA BAK (CEO)
(916) 569-8484
Entity
Organization
Contact information
Practice address
3701 J ST STE 201, SACRAMENTO, CA 95816-5542
(916) 454-2345
(916) 890-3828
Mailing address
1860 HOWE AVE STE 440, SACRAMENTO, CA 95825-1098
(916) 569-8484
(916) 256-2214
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
Other
Enumeration date
02/27/2014
Last updated
03/08/2022
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