Organization
MENDOCINO COAST CLINICS, INC.
Active
Organization
MENDOCINO COAST CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULA COHEN (EXECUTIVE DIRECTOR)
(707) 964-1251
Entity
Organization
Contact information
Practice address
855 SEQUOIA CIRCLE, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMM71141F
—
CA
Enumeration date
02/11/2008
Last updated
06/09/2020
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