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The Q2 2025 registration window for covered entities is open from 4/1/2025 - 4/15/2025.
FQHCLA397A Health Service Alliance (Active)
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Main Details
Name
Health Service Alliance
Subdivision Name
Montclair Community Health Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-028007
340B ID
FQHCLA397A
Grant Number
LALCS33333
Additional Details
Current Program Status
Active
Registration Date
9/9/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/10/2019
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Health Service Alliance
Jeff Cox, Chief Executive Officer
(909) 784-6117
Primary Contact
Health Service Alliance
Christen Grelling, Chief Operations Officer
(909) 464-9675 Ext: 104
Addresses
Street Address
5050 San Bernardino St
Montclair, CA 91763-2326
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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