Provider Demographics
NPI: | 1306033220 |
---|---|
Name: | COUNTY OF MONTEREY BEHAVIORAL HEALTH |
Entity Type: | Organization |
Organization Name: | COUNTY OF MONTEREY BEHAVIORAL HEALTH |
Other - Org Name: | MONTEREY COUNTY BEHAVIORAL HEALTH KING CITY CLINIC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | MEDICAL RECORDS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SEMO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 831-755-4332 |
Mailing Address - Street 1: | 200 BROADWAY ST |
Mailing Address - Street 2: | SUITE 88 |
Mailing Address - City: | KING CITY |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 93930-2865 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 831-386-6868 |
Mailing Address - Fax: | 831-386-6877 |
Practice Address - Street 1: | 200 BROADWAY ST |
Practice Address - Street 2: | SUITE 88 |
Practice Address - City: | KING CITY |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93930-2865 |
Practice Address - Country: | US |
Practice Address - Phone: | 831-386-6868 |
Practice Address - Fax: | 831-386-6877 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-09-25 |
Last Update Date: | 2015-09-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |