Provider Demographics
NPI:1609091461
Name:CHILDREN'S BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:CHILDREN'S BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILDREN'S PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:530-470-2736
Mailing Address - Street 1:988 MCCOURTNEY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949-7400
Mailing Address - Country:US
Mailing Address - Phone:530-470-2736
Mailing Address - Fax:
Practice Address - Street 1:988 MCCOURTNEY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95949-7400
Practice Address - Country:US
Practice Address - Phone:530-470-2736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA COUNTY BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-16
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health