Provider Demographics
NPI:1073919171
Name:NATIVE AMERICAN MENTAL HEALTH SERVICES CORPORATION
Entity Type:Organization
Organization Name:NATIVE AMERICAN MENTAL HEALTH SERVICES CORPORATION
Other - Org Name:NORTH AMERICAN MENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:530-226-7419
Mailing Address - Street 1:1742 OREGON STREET
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001
Mailing Address - Country:US
Mailing Address - Phone:530-646-7269
Mailing Address - Fax:
Practice Address - Street 1:1742 OREGON STREET
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-646-7269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIVE AMERICAN MENTAL HEALTH SERVICES CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-17
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty