| Dmh Integrated Services For Homeless Adults | |
|
415 Humboldt St Santa Rosa CA 95404-4214 | |
| (707) 565-4850 | |
| Not Available |
| Full Name | Dmh Integrated Services For Homeless Adults |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 415 Humboldt St, Santa Rosa, California |
| Authorized Official Name and Position | Diana Stornetta (COMPLIANCE AUDITOR ACCOUNTANT III) |
| Authorized Official Contact | 7075654782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dmh Integrated Services For Homeless Adults 415 Humboldt St Santa Rosa CA 95404-4214 Ph: () - | Dmh Integrated Services For Homeless Adults 415 Humboldt St Santa Rosa CA 95404-4214 Ph: (707) 565-4850 |
| NPI Number | 1255547600 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255547600 | NPI | - | NPPES |
| 49AN | Other | CA | PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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