Organization Name: | EL DORADO COUNTY MENTAL HEALTH |
NPI Number: | 1316158082 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICIA JUDITH CHARLES-HEATHERS (ASST. DIRECTOR OF HEALTH SERVICES) |
Mailing Address: | 768 Pleasant Valley Road Diamond Springs |
State: | CA US |
Postal Code: | 95619 |
Phone Number: | 5306216290 |
Fax Number: | 5306221293 |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 01/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 0958 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |