| Open Line Group Homes, Inc. | |
|
4625 Mountain Lakes Blvd Redding CA 96003-1450 | |
| (530) 246-7172 | |
| Not Available |
| Full Name | Open Line Group Homes, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4625 Mountain Lakes Blvd, Redding, California |
| Authorized Official Name and Position | Miranda Robinson (MENTAL HEALTH DIRECTOR) |
| Authorized Official Contact | 5302467172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Line Group Homes, Inc. Po Box 992197 Redding CA 96099-2197 Ph: (530) 246-7172 | Open Line Group Homes, Inc. 4625 Mountain Lakes Blvd Redding CA 96003-1450 Ph: (530) 246-7172 |
| NPI Number | 1801486105 |
|---|---|
| Provider Enumeration Date | 01/20/2021 |
| Last Update Date | 01/20/2021 |
| Certification Date | 01/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801486105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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