Provider Demographics
NPI:1982810107
Name:TEHAMA COUNTY HEALTH SERVICES AGENCY
Entity Type:Organization
Organization Name:TEHAMA COUNTY HEALTH SERVICES AGENCY
Other - Org Name:TEHAMA COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAYME
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-527-8491
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-0400
Mailing Address - Country:US
Mailing Address - Phone:530-527-8491
Mailing Address - Fax:530-527-0240
Practice Address - Street 1:818 MAIN ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2759
Practice Address - Country:US
Practice Address - Phone:530-527-8491
Practice Address - Fax:530-527-0240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEHAMA COUNTY HEALTH SERVICES AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-15
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local