Provider Demographics
NPI:1255703716
Name:NATIVE AMERICAN MENTAL HEALTH SERVICES CORPORATION
Entity type:Organization
Organization Name:NATIVE AMERICAN MENTAL HEALTH SERVICES CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:530-646-7269
Mailing Address - Street 1:414 4TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4000
Mailing Address - Country:US
Mailing Address - Phone:530-406-7993
Mailing Address - Fax:530-406-7996
Practice Address - Street 1:414 4TH ST STE D
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4000
Practice Address - Country:US
Practice Address - Phone:530-406-7993
Practice Address - Fax:530-406-7996
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIVE AMERICAN MENTAL HEALTH SERVICES CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-23
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty