Provider Demographics
NPI:1487829693
Name:HOOPA VALLEY BUSINESS COUNCIL HOOPA VALLEY TRIBE
Entity Type:Organization
Organization Name:HOOPA VALLEY BUSINESS COUNCIL HOOPA VALLEY TRIBE
Other - Org Name:HOOPA VALLEY TRIBE-DIVISION OF HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MILLIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-625-4236
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:HOOPA
Mailing Address - State:CA
Mailing Address - Zip Code:95546-1267
Mailing Address - Country:US
Mailing Address - Phone:530-625-4236
Mailing Address - Fax:530-625-4258
Practice Address - Street 1:2 ORCHARD AVE
Practice Address - Street 2:
Practice Address - City:HOOPA
Practice Address - State:CA
Practice Address - Zip Code:95546-1267
Practice Address - Country:US
Practice Address - Phone:530-625-4236
Practice Address - Fax:530-625-4258
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOOPA VALLEY BUSINESS COUNCIL HOOPA VALLEY TRIBE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-29
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAEXEMPT INDIAN TRIBE261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)