Provider Demographics
NPI: | 1245398676 |
---|---|
Name: | COUNTY OF BUTTE |
Entity Type: | Organization |
Organization Name: | COUNTY OF BUTTE |
Other - Org Name: | PSYCHIATRIC HEALTH FACILITY |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SCOTT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KENNELLY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 530-891-2850 |
Mailing Address - Street 1: | 3217 COHASSET RD |
Mailing Address - Street 2: | |
Mailing Address - City: | CHICO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95973-5404 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 530-891-2980 |
Mailing Address - Fax: | 530-895-6548 |
Practice Address - Street 1: | 592 RIO LINDO AVENUE |
Practice Address - Street 2: | |
Practice Address - City: | CHICO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 95926 |
Practice Address - Country: | US |
Practice Address - Phone: | 530-891-2775 |
Practice Address - Fax: | 530-895-6547 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-05 |
Last Update Date: | 2020-09-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 1016001 | 261QM0850X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |