Organization
TRI-STATE COMMUNITY HEALTHCARE CENTER
Active
Parent organization
TRI-STATE COMMUNITY HEALTHCARE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE COMMUNITY HEALTHCARE CENTER
Authorized official
CRYSTALE MINEROS (MANAGED CARE DIRECTOR)
(323) 297-0884
Entity
Organization
Contact information
Practice address
11328 BARTLETT AVE STE 3, ADELANTO, CA 92301-1913
(760) 237-8848
(760) 237-8847
Mailing address
11328 BARTLETT AVE STE 3, ADELANTO, CA 92301-1913
(760) 530-9944
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
04/30/2021
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