Provider Demographics
NPI:1174693493
Name:THE WECARE GROUP, INC.
Entity type:Organization
Organization Name:THE WECARE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GRAYLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-574-6616
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 1:321 VAN DUZEN ROAD
Practice Address - Street 2:
Practice Address - City:MAD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95552-0004
Practice Address - Country:US
Practice Address - Phone:707-574-6616
Practice Address - Fax:707-574-6523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2300000060207Q00000X
261QF0400X
CA230000060261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM70040FMedicaid
CAFHC70040FMedicaid
CAZZZ80700ZMedicare PIN
CARHM70040FMedicaid