MENDOCINO COMMUNITY HEALTH CLINIC, INC. – NPI #1922020585
Clinic/Center

MENDOCINO COMMUNITY HEALTH CLINIC, INC. is an AHC clinic located in WILLITS, CA. NPPES has assigned the NPI number 1922020585 to MENDOCINO COMMUNITY HEALTH CLINIC, INC. on July 24, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. MENDOCINO COMMUNITY HEALTH CLINIC, INC. is also known by the name LITTLE LAKE HEALTH CENTER. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 7 years ago on May 03, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MENDOCINO COMMUNITY HEALTH CLINIC, INC. below.

NPI Profile for
MENDOCINO COMMUNITY HEALTH CLINIC, INC.

NPI Number
1922020585
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Other Name: LITTLE LAKE HEALTH CENTER
Primary location
45 HAZEL ST
WILLITS, CA 95490
Phone: (707) 456-9600 Fax:
Mailing address
333 LAWS AVE
UKIAH, CA 95482-6540
Phone: (707) 468-1010 Fax:
Organization Subpart
No
Authorized Official
TIM DOLAN
CFO
Phone: (707) 467-2260
Updated
Identifiers

Identifiers for MENDOCINO COMMUNITY HEALTH CLINIC, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERFAMILYPACTCAHAP70968F
MEDICAIDCAFHC70968F
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
261Q00000X
- Clinic/Center		 CA 110000500

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.