National Provider Identifier Database

SOUTHERN TRINITY HEALTH INC
Federally Qualified Health Center (FQHC)

A Federally Qualified Health Center (FQHC) is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.


Contact Information

SOUTHERN TRINITY HEALTH INC
153-A VAN DUZEN RD
MAD RIVER, CA95552
Phone: 707-574-6616
Fax: 707-574-6523
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

NPI Profile & details for SOUTHERN TRINITY HEALTH INC

NPI Number 1316121007
Legal business name
LBN
SOUTHERN TRINITY HEALTH INC
Authorized official GRAYLAN LUPTON - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 12/18/2007
Last updated 04/21/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • CA Medicaid: EAP70040F

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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