Provider Demographics
NPI:1235312760
Name:AMADOR-TUOLUMNE COMMUNITY ACTION AGENCY
Entity Type:Organization
Organization Name:AMADOR-TUOLUMNE COMMUNITY ACTION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-533-1397
Mailing Address - Street 1:935 S HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:CA
Mailing Address - Zip Code:95642-2673
Mailing Address - Country:US
Mailing Address - Phone:209-223-1485
Mailing Address - Fax:209-223-4178
Practice Address - Street 1:427 HIGHWAY 49
Practice Address - Street 2:SUITE 103
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5666
Practice Address - Country:US
Practice Address - Phone:209-533-9617
Practice Address - Fax:209-533-9620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management