Organization
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Active
Organization
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Active
Other names
Little Lake Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM DOLAN (CFO)
(707) 467-2260
Entity
Organization
Contact information
Practice address
45 HAZEL ST, WILLITS, CA 95490
(707) 456-9600
Mailing address
333 LAWS AVE, UKIAH, CA 95482-6540
(707) 468-1010
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
110000500
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70968F
—
CA
01
—
HAP70968F
FAMILYPACT
CA
Enumeration date
07/24/2006
Last updated
05/03/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up