Borrego Community Health Foundation
NPI #1558925016 in Lake Elsinore, California
Provider Information
- NPI Number
- 1558925016
- Entity Type
- Organization
- Organization Name
- Borrego Community Health Foundation
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- BORREGO COMMUNITY HEALTH FOUNDATION
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Apr 30, 2019
- Last Updated
- Apr 30, 2019
Practice Location
- Address
- 31739 RIVERSIDE DR STE A1
- City
- Lake Elsinore
- State
- California
- ZIP Code
- 92530-7818
- Phone
- (619) 873-3538
Authorized Official
- Name
- MIKIA BRAYTON WALLIS
- Title
- CEO
- Phone
- (760) 767-6641
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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