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FQHCLA477 AIDS SERVICES FOUNDATION ORANGE COUNTY (Active)
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Main Details
Name
AIDS SERVICES FOUNDATION ORANGE COUNTY
Subdivision Name
Radiant Health Centers
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-039084
340B ID
FQHCLA477
Grant Number
LALCS53696
Additional Details
Current Program Status
Active
Registration Date
10/14/2024
Participating Start Date
1/1/2025
Participating Approval Date
11/13/2024
Last Recertification Date
2/27/2025
Contacts
Authorizing Official
AIDS Services Foundation Orange County dba Radiant Health Centers
Danielle Nagao, CFO
(714) 264-2709
Primary Contact
AIDS Services Foundation Orange County dba Radiant Health Centers
Brandi Tatman, Project Manager
(949) 809-5723
Addresses
Street Address
17982 Sky Park Cir STE J
Irvine, CA 92614-6482
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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