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Organization

BLUE LAKE RANCHERIA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASON RAMOS DC (TRIBAL ADMINSTRATOR)
(707) 668-7226
Entity
Organization

Contact information

Practice address
428 CHARTIN RD, BLUE LAKE, CA 95525-9722
(707) 668-5101
(707) 668-7226
Mailing address
PO BOX 428, BLUE LAKE, CA 95525-0428
(707) 668-7226

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
251B00000X
Case Management Agency
251K00000X
Public Health or Welfare Agency
261Q00000X
Clinic/Center
Primary
261QC1500X
Community Health Clinic/Center
261QF0050X
Non-Surgical Family Planning Clinic/Center
261QM0850X
Adult Mental Health Clinic/Center
332U00000X
Home Delivered Meals
385H00000X
Respite Care

Other

Enumeration date
10/03/2024
Last updated
10/03/2024
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