Provider Demographics
NPI:1326318080
Name:LASSEN COUNTY
Entity Type:Organization
Organization Name:LASSEN COUNTY
Other - Org Name:BIG VALLEY ONE STOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY COUNTY ADMINISTRATIVE OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-251-8112
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:BIEBER
Mailing Address - State:CA
Mailing Address - Zip Code:96009-0040
Mailing Address - Country:US
Mailing Address - Phone:530-294-5700
Mailing Address - Fax:530-294-0040
Practice Address - Street 1:125 HWY 299 EAST
Practice Address - Street 2:
Practice Address - City:BIEBER
Practice Address - State:CA
Practice Address - Zip Code:96009
Practice Address - Country:US
Practice Address - Phone:530-294-5700
Practice Address - Fax:530-294-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1801Medicaid