Provider Demographics
NPI:1750715801
Name:KINGS COUNTY BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:KINGS COUNTY BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-852-2444
Mailing Address - Street 1:1400 W LACEY BLVD BLDG 13
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5905
Mailing Address - Country:US
Mailing Address - Phone:559-582-2444
Mailing Address - Fax:559-589-6916
Practice Address - Street 1:1222 W LACEY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5901
Practice Address - Country:US
Practice Address - Phone:559-852-2444
Practice Address - Fax:559-589-6916
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINGS COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-26
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health