Big Oak Peer Support Center | |
13300 E Highway 20 Ste O Clearlake Oaks CA 95423-9436 | |
(707) 998-0310 | |
Not Available |
Full Name | Big Oak Peer Support Center |
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Speciality | Community/behavioral Health |
Location | 13300 E Highway 20 Ste O, Clearlake Oaks, California |
Authorized Official Name and Position | Elise Jones Ma (DIRECTOR) |
Authorized Official Contact | 7072749101 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Big Oak Peer Support Center Po Box 1024 Lucerne CA 95458-1024 Ph: (707) 998-0310 | Big Oak Peer Support Center 13300 E Highway 20 Ste O Clearlake Oaks CA 95423-9436 Ph: (707) 998-0310 |
NPI Number | 1598505364 |
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Provider Enumeration Date | 05/29/2024 |
Last Update Date | 08/26/2024 |
Certification Date | 08/26/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598505364 | NPI | - | NPPES |
17EZ | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |