Provider Demographics
NPI:1285830992
Name:COLUSA COUNTY DEPARTMENT OF SUBSTANCE ABUSE
Entity Type:Organization
Organization Name:COLUSA COUNTY DEPARTMENT OF SUBSTANCE ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:JOINER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:530-458-0824
Mailing Address - Street 1:162 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-2866
Mailing Address - Country:US
Mailing Address - Phone:530-458-0520
Mailing Address - Fax:
Practice Address - Street 1:162 E CARSON ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2866
Practice Address - Country:US
Practice Address - Phone:530-458-0520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health