Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI Number | 1962273011 |
| LBN Legal business name | SIERRA VISTA REGIONAL HEALTH CENTER MEDICAL GROUP LLC |
| Authorized official | CHARLOTTE LAWRENCE - (SECRETARY) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/09/2024 |
| Last updated | 09/26/2024 - More than a year ago |
| Identifiers | n/a |
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