Basic Information
| Provider Information | |||||||||
| NPI: | 1285352120 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COUNTY OF BUTTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3217 COHASSET RD | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959735404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308912850 | ||||||||
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| Practice Location | |||||||||
| Address1: | 560 COHASSET RD STE 120 | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959262281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308912850 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2022 | ||||||||
| LastUpdateDate: | 08/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | KENNELLY | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5308912850 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | L.C.S.W. | ||||||||
| NPICertificationDate: | 08/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.