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CH09879L SANTA ROSA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
Roseland Children's Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007587
340B ID
CH09879L
Grant Number
H80CS00259
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/15/2014
Last Recertification Date
3/4/2015
Termination Date
Termination Reason
1/1/2016
Site closure
Contacts
Authorizing Official
Kai Nissley, COO
(707) 303-3600 Ext: 3430
Primary Contact
Kai Nissley, COO
(707) 303-3600 Ext: 3430
Addresses
Street Address
962 Sebastopol Rd
Santa Rosa, CA 95407-6829
Billing Address
Santa Rosa Community Health Centers
3569 Round Barn Circle
Santa Rosa, CA 95403
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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