Provider Demographics
NPI:1003024449
Name:MAKING HEADWAY CENTER FOR BRAIN INJURY RECOVERY
Entity Type:Organization
Organization Name:MAKING HEADWAY CENTER FOR BRAIN INJURY RECOVERY
Other - Org Name:MAKING HEADWAY CENTER FOR BRAIN INJURY RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTHROP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-442-7668
Mailing Address - Street 1:730 K ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1123
Mailing Address - Country:US
Mailing Address - Phone:707-442-7668
Mailing Address - Fax:707-443-8839
Practice Address - Street 1:730 K ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1123
Practice Address - Country:US
Practice Address - Phone:707-442-7668
Practice Address - Fax:707-443-8839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health