Provider Demographics
NPI:1619589959
Name:MCNAMAR RESIDENTIAL
Entity Type:Organization
Organization Name:MCNAMAR RESIDENTIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIRBRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-321-0265
Mailing Address - Street 1:PO BOX 6582
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-6582
Mailing Address - Country:US
Mailing Address - Phone:530-321-0265
Mailing Address - Fax:530-965-5786
Practice Address - Street 1:2743 LOWELL DR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7216
Practice Address - Country:US
Practice Address - Phone:530-345-6420
Practice Address - Fax:530-809-0984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities