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CH09312AW FAMILY HEALTH CENTERS OF SAN DIEGO, INC. (Active)
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Main Details
Name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Subdivision Name
Logan Heights Family Counseling Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005018
340B ID
CH09312AW
Grant Number
H80CS00224
Additional Details
Current Program Status
Active
Registration Date
6/11/2008
Participating Start Date
7/1/2008
Participating Approval Date
6/11/2008
Last Recertification Date
3/1/2025
Contacts
Authorizing Official
Family Health Centers of San Diego
Ricardo Roman, CFO
(619) 906-4603
Primary Contact
Family Health Centers of San Diego, Inc.
Nichole M Laferriere, Business Analyst II
(619) 255-7313
Addresses
Street Address
2204 National Ave
San Diego, CA 92113-3615
Billing Address
Family Health Centers of San Diego, Inc.
823 Gateway Center Way
San Diego, CA 92102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/19/10 UPDATED SUB DIV NAME (WAS HILLCREST COUNSELING CENTER), UPDATED PHYS ADD (WAS 550 WASHINGTON ST, #201, SAN DIEGO), DELETED SHIP ADD (WAS 5335 MARKET ST, SAN DIEGO), ADDED NPI#
10/19/2010
May 2025
May 2025
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