Organization
ROOTS COMMUNITY HEALTH CENTER
Active
Parent organization
ROOTS COMMUNITY HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROOTS COMMUNITY HEALTH CENTER
Authorized official
JERUSHA NORMAN (COMPLIANCE ADMINISTRATOR)
(510) 994-6849
Entity
Organization
Contact information
Practice address
7272 MACARTHUR BLVD, OAKLAND, CA 94605
(510) 777-1177
(510) 550-2644
Mailing address
9925 INTERNATIONAL BLVD STE 5, OAKLAND, CA 94603-2558
(510) 777-1177
(510) 550-2644
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
251X00000X
Supports Brokerage Agency
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2019
Last updated
03/28/2022
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