Organization
CONSOLIDATED TRIBAL HEALTH PROJECT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE PROVENCHER (EXECUTIVE DIRECTOR)
(707) 485-5115
Entity
Organization
Contact information
Practice address
6991 N STATE ST, REDWOOD VALLEY, CA 95470-9629
(707) 485-5115
(707) 485-7837
Mailing address
947 N OAK ST, UKIAH, CA 95482-3905
(707) 485-5115
(707) 485-7837
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
44306
CA
Other
Enumeration date
08/23/2006
Last updated
08/22/2020
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