Provider Demographics
NPI:1235499450
Name:SLO COUNTY B.H.
Entity Type:Organization
Organization Name:SLO COUNTY B.H.
Other - Org Name:SLO COUNTY MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICIAL FOR THE ORGANIZATION
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-781-4700
Mailing Address - Street 1:2178 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401
Mailing Address - Country:US
Mailing Address - Phone:805-781-4700
Mailing Address - Fax:
Practice Address - Street 1:2178 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-781-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SAN LUIS OBISPO, MENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28690283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital