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CH093120 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 Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001706
340B ID
CH093120
Grant Number
H80CS00224
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
5/12/2004
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
1809 National Ave
San Diego, CA 92113-2113
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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10/7/10 ADDED BILL-TO ADD, ADDED NPI #, UPDATED SUBDIV NAME (WAS LOGAN HEIGHTS CLINIC)
10/07/2010
May 2025
May 2025
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