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COUNTY OF MENDOCINO

Agencies Public Health or Welfare

Provider NPI: 1437296282

Organization Information:
Organization Name:  COUNTY OF MENDOCINO
Organization is not Subpart
Authorized Official:  JENINE  MILLER  BHRS DEPUTY DIRECTOR  707-472-2637

Practice Location:
1120 S DORA ST  UKIAH, CA 95482-6340 US
Tel: 707-472-2637  Fax: 707-472-2657

Business Mailing Address:
1120 S DORA ST  UKIAH, CA 95482-6340 US
Tel: 707-472-2637  Fax: 707-472-2657

NPI Information:
NPI: 1437296282
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N251K00000XAgencies
Public Health or Welfare
N261QP0904XAmbulatory Health Care Facilities
Clinic/Center
N261QP0905XAmbulatory Health Care Facilities
Clinic/Center
Y251S00000XAgencies
Community/Behavioral Health

Other Provider Identifiers:

IssuerNumberStateType
UKIAH DRUG MEDICAL #2305CA01



American Medical Association 2012 taxonomy code information

Code: 251S00000X

Type:

Classification:



Definition:



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