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CHC24114-02 SANTA CRUZ COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
SANTA CRUZ COMMUNITY HEALTH CENTERS
Subdivision Name
Santa Cruz Mountain Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-033574
340B ID
CHC24114-02
Grant Number
H80CS24114
Additional Details
Current Program Status
Terminated
Registration Date
1/17/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/19/2023
Last Recertification Date
1/30/2024
Termination Date
Termination Reason
4/1/2024
Site closure
Contacts
Authorizing Official
Santa Cruz Community Health Centers
Leslie Conner, Executive Director
(831) 427-3582 Ext: 134
Primary Contact
SCCHC
Ruth Jasso, Revenue Cycle Director
(831) 427-3500 Ext: 142
Addresses
Street Address
9500 Central Ave
Ben Lomond, CA 95005-9349
Billing Address
Santa Cruz Community Health Centers
PO Box 542
Santa Cruz, CA 95061
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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