TRI-STATE COMMUNITY HEALTHCARE CENTER NPI 1508379017

NPI Information

NPI: 1508379017
Provider Name: TRI-STATE COMMUNITY HEALTHCARE CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
11888 BARTLETT AVE
ADELANTO, CA
ZIP 92301
Phone: (760) 530-9944
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TRI-STATE COMMUNITY HEALTHCARE CENTER is a federally qualified health center (fqhc) clinic center in Adelanto, CA. TRI-STATE COMMUNITY HEALTHCARE CENTER NPI is 1508379017. The provider is registered as an organization entity type.

The provider's business location address is:

11888 BARTLETT AVE
ADELANTO, CA
ZIP 92301-709
Phone: (760) 530-9944
Fax: (760) 530-9977

The provider's authorized official is Crystale Mineros .
The authorized official title is Managed Care Director and has the following contact phone number (323) 297-0884.

The enumeration date for this NPI number is 11/7/2017 and was last updated on 3/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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