Provider Demographics
NPI:1942368378
Name:COUNTY OF BUTTE
Entity Type:Organization
Organization Name:COUNTY OF BUTTE
Other - Org Name:BUTTE DBH OROVILLE COMMUNITY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILNER
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:530-879-3367
Mailing Address - Street 1:109 PARMAC ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2218
Mailing Address - Country:US
Mailing Address - Phone:530-891-2980
Mailing Address - Fax:530-895-6548
Practice Address - Street 1:88 TABLE MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-3578
Practice Address - Country:US
Practice Address - Phone:530-538-2158
Practice Address - Fax:530-533-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ42951ZMedicare PIN