Provider Demographics
NPI:1770328635
Name:FIRST 5 MENDOCINO
Entity type:Organization
Organization Name:FIRST 5 MENDOCINO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TOWNLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:707-462-4453
Mailing Address - Street 1:419 TALMAGE ROAD, SUITE J
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482
Mailing Address - Country:US
Mailing Address - Phone:707-462-4453
Mailing Address - Fax:707-462-5570
Practice Address - Street 1:419 TALMAGE ROAD, SUITE J
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482
Practice Address - Country:US
Practice Address - Phone:707-462-4453
Practice Address - Fax:707-462-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty