Provider Demographics
NPI:1811545429
Name:NATIVE AMERICAN MENTAL HEALTH SERVICES CORPORATION
Entity Type:Organization
Organization Name:NATIVE AMERICAN MENTAL HEALTH SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:
Authorized Official - First Name:BENTON
Authorized Official - Middle Name:C
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:530-226-7419
Mailing Address - Street 1:800 W HARRIS ST STE 33
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-3929
Mailing Address - Country:US
Mailing Address - Phone:707-296-7660
Mailing Address - Fax:
Practice Address - Street 1:800 W HARRIS ST STE 33
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-3929
Practice Address - Country:US
Practice Address - Phone:707-296-7660
Practice Address - Fax:707-296-7661
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIVE AMERICAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-27
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty