| None | |
|
686-700 Highway 36 Susanville CA 96130-0444 | |
| (530) 257-9266 | |
| Not Available |
| Full Name | None |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 686-700 Highway 36, Susanville, California |
| Authorized Official Name and Position | William Harry Graf (ON CALL MENTEL HEALTH CONTRACTOR) |
| Authorized Official Contact | 5302579366 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None Po Box 444 Susanville CA 96130-0444 Ph: (530) 257-9266 | None 686-700 Highway 36 Susanville CA 96130-0444 Ph: (530) 257-9266 |
| NPI Number | 1831256312 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 09/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831256312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | NONE (* (Not Available)) | Primary |
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