Provider Demographics
NPI:1255898953
Name:THE WECARE GROUP, INC.
Entity type:Organization
Organization Name:THE WECARE GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:AULTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-764-5617
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:CA
Mailing Address - Zip Code:95565-0007
Mailing Address - Country:US
Mailing Address - Phone:707-764-5617
Mailing Address - Fax:707-783-5618
Practice Address - Street 1:100 HORSESHOE LANE
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:CA
Practice Address - Zip Code:96093
Practice Address - Country:US
Practice Address - Phone:530-623-8888
Practice Address - Fax:530-623-8887
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE WECARE GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-28
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ80700ZOtherMEDICARE PIN
CARHM70040FMedicaid
CA051026Medicaid
CAFHC70040FMedicaid