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COUNTY OF MENDOCINO

Agencies Public Health or Welfare

Provider NPI: 1063558823

Organization Information:
Organization Name:  COUNTY OF MENDOCINO
Authorized Official:  PATRICIA  GUNTLY  PROGRAM DIRECTOR  707-472-2607

Practice Location:
221 S LENORE AVE  WILLITS, CA 95490-3632 US
Tel: 707-456-3821  Fax: --

Business Mailing Address:
221 S LENORE AVE  WILLITS, CA 95490-3632 US
Tel: 707-456-3821  Fax: --

NPI Information:
NPI: 1063558823
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X251K00000XAgencies
Public Health or Welfare
X261QP0904XAmbulatory Health Care Facilities
Clinic/Center
X261QP0905XAmbulatory Health Care Facilities
Clinic/Center

Other Provider Identifiers:

IssuerNumberStateType
DRUG MEDICAL WILLITS2302CA01




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