Organization · Type 2 NPI
Potential Way
Lodging Provider · Clearlake Oaks, CA
NPI number
1588434849
Active
Practice location
12901 E Highway 20
Clearlake Oaks, CA 95423-9326
Fax (707) 703-5792
Mailing address
PO Box 516
Clearlake Oaks, CA 95423-0516
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Meals Provider | 174200000X | None listed |
| Lodging Provider Primary | 177F00000X | None listed |
| Case Management Agency | 251B00000X | None listed |
| Home Health Agency | 251E00000X | None listed |
Lodging Provider: A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
About NPI 1588434849
Potential Way's National Provider Identifier is 1588434849, issued on Jan 8, 2024. The primary taxonomy on file is Lodging Provider (177F00000X), and the practice location is in Clearlake Oaks, CA. The record was last updated on Jan 8, 2024.