| Prime Healthcare Services - Shasta Llc | |
|
1100 Butte St Redding CA 96001-0852 | |
| (530) 244-5454 | |
| Not Available |
| Full Name | Prime Healthcare Services - Shasta Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1100 Butte St, Redding, California |
| Authorized Official Name and Position | Christopher Doan (MANAGING ASSOCIATE GENERAL COUNSEL) |
| Authorized Official Contact | 3102594706 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Healthcare Services - Shasta Llc 1100 Butte St Redding CA 96001-0852 Ph: (530) 244-5454 | Prime Healthcare Services - Shasta Llc 1100 Butte St Redding CA 96001-0852 Ph: (530) 244-5454 |
| NPI Number | 1134569650 |
|---|---|
| Provider Enumeration Date | 06/28/2013 |
| Last Update Date | 04/14/2022 |
| Certification Date | 04/14/2022 |
| Medicare PECOS PAC ID | 7416012851 |
|---|---|
| Medicare Enrollment ID | O20160114000112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134569650 | NPI | - | NPPES |
| 0177738 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 230000023 (California) | Primary |
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