Provider Demographics
NPI:1790964641
Name:COUNTY OF SACRAMENTO
Entity Type:Organization
Organization Name:COUNTY OF SACRAMENTO
Other - Org Name:DHHS ADULT GUARDIAN PUBLIC CONSERVATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISION MANAGER SR ADULT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:BERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-874-9598
Mailing Address - Street 1:7001A EAST PKWY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2501
Mailing Address - Country:US
Mailing Address - Phone:916-875-5000
Mailing Address - Fax:
Practice Address - Street 1:3331 POWER INN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3889
Practice Address - Country:US
Practice Address - Phone:916-875-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SACRAMENTO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management