NPIMap

Organization Active NPI

Open Door Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
National Provider Identifier
1174250492
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OPEN DOOR COMMUNITY HEALTH CENTER
Doing business as
Eureka City Schools Wellness Center
Practice address
1915 J St
Eureka, CA 95501-3052
Phone
(707) 443-4666
NPI assigned
Aug 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Victor Starr
Title
President and Executive Officer
Phone
(707) 826-8633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1915 J St
Eureka, CA 95501-3052

Mailing address

1275 8TH St
Arcata, CA 95521-5770
Phone (707) 826-8633

Other names 1

  • Eureka City Schools Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Smith River Community11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1915 J St
Eureka, CA 95501
Phone (707) 441-2508

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1174250492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 8TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215770",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 J ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013052",
            "telephone_number": "707-443-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "STARR",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT AND EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-826-8633"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eureka City Schools Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eureka City Schools Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.