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CHC28371-00 SOUTHLAND INTEGRATED SERVICES INC (Active)
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Main Details
Name
SOUTHLAND INTEGRATED SERVICES INC
Subdivision Name
Southland Integrated Services, Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015124
340B ID
CHC28371-00
Grant Number
H80CS28371
Additional Details
Current Program Status
Active
Registration Date
7/6/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/6/2023
Last Recertification Date
2/28/2025
Contacts
Authorizing Official
Southland Integrated Services, Inc.
Tricia Nguyen, CEO
(714) 620-7007
Primary Contact
Southland Integrated Services, Inc.
Tiffany Nguyen, Program Director
(714) 620-7075
Addresses
Street Address
9862 Chapman Avenue
Garden Grove, CA 92841-2726
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Participating from effective date: (01/1/2016) until terminated effective date: (04/1/2021); reinstatement effective date: (10/1/2023)
07/12/2023
April 2025
April 2025
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