Provider Demographics
NPI:1376051367
Name:BUTTE COUNTY DEPARTMENT OF BEHAVIORAL HEATH
Entity Type:Organization
Organization Name:BUTTE COUNTY DEPARTMENT OF BEHAVIORAL HEATH
Other - Org Name:AAFCC - BH
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERVISOR, BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ISIDORE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-891-2765
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:
Practice Address - Street 1:3300 SPENCER AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6587
Practice Address - Country:US
Practice Address - Phone:530-891-2980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health