Provider Demographics
NPI:1912768714
Name:UNITED INDIAN HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:UNITED INDIAN HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:707-825-4065
Mailing Address - Street 1:1600 WEEOT WAY
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-4734
Mailing Address - Country:US
Mailing Address - Phone:707-825-5000
Mailing Address - Fax:
Practice Address - Street 1:525 7TH ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-6806
Practice Address - Country:US
Practice Address - Phone:707-825-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED INDIAN HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental