Provider Demographics
NPI:1801019922
Name:COUNTY OF MADERA
Entity Type:Organization
Organization Name:COUNTY OF MADERA
Other - Org Name:OAKHURST COUNSELING CENTER MH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BEHAVIORAL HEALTH SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:559-673-3508
Mailing Address - Street 1:PO BOX 1288
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93639-1288
Mailing Address - Country:US
Mailing Address - Phone:559-673-3508
Mailing Address - Fax:559-675-4999
Practice Address - Street 1:49774 ROAD 426
Practice Address - Street 2:SUITE D
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-8690
Practice Address - Country:US
Practice Address - Phone:559-683-4809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2055OtherDEPT. OF MENTAL HEALTH