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
StateLicense IDTaxonomies
CA1016001261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health