| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 720 Wood St, Eureka, California |
| Authorized Official Name and Position | Emi Botzler-rogers (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 7072682990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
720 Wood St Eureka CA 95501-4413 Ph: (707) 268-2900 | 720 Wood St Eureka CA 95501-4413 Ph: (707) 268-2900 |
| NPI Number | 1194763219 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 09/03/2021 |
| Certification Date | 09/03/2021 |
| Medicare PECOS PAC ID | 4082516950 |
|---|---|
| Medicare Enrollment ID | O20090212000380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194763219 | NPI | - | NPPES |
| 000001229 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 273R00000X | Psychiatric Unit | 1 01 6003 (California) | Primary |
Humboldt Family Service Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1802 California St, Eureka, CA 95501 Phone: 707-443-7358 | |
Narum Clinical Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 930 3rd St, Suite 201, Eureka, CA 95501 Phone: 707-441-8626 Fax: 707-442-5040 | |