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494 Pacific Ave Crescent City CA 95531-3142 | |
| (707) 464-5500 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 494 Pacific Ave, Crescent City, California |
| Authorized Official Name and Position | Lacinda Beardon (SENIOR ACCOUNT CLERK) |
| Authorized Official Contact | 7074647224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
455 K St Crescent City CA 95531-4107 Ph: (707) 464-7224 | 494 Pacific Ave Crescent City CA 95531-3142 Ph: (707) 464-5500 |
| NPI Number | 1013163310 |
|---|---|
| Provider Enumeration Date | 08/18/2008 |
| Last Update Date | 07/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013163310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
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