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FQHCLA469 LYON-MARTIN COMMUNITY HEALTH SERVICES (Active)
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Main Details
Name
LYON-MARTIN COMMUNITY HEALTH SERVICES
Subdivision Name
Lyon-Martin Community Health Services
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-038591
340B ID
FQHCLA469
Grant Number
LALCS53018
Additional Details
Current Program Status
Active
Registration Date
7/11/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/25/2024
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
Lyon-Martin Community Health Services
Jackson James Miller Jaffe, CEO
(415) 901-7108
Primary Contact
Lyon-Martin Community Health Services
Makisha Maier, COO
(415) 798-6517
Addresses
Street Address
1735 Mission St
San Francisco, CA 94103-2417
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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