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154-b Tule Creek Road Hayfork CA 96041 | |
| (530) 628-4111 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 154-b Tule Creek Road, Hayfork, California |
| Authorized Official Name and Position | Connie Smith (DIRECTOR) |
| Authorized Official Contact | 5306238293 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
P.o. Box 91 Hayfork CA 96041 Ph: (530) 628-4111 | 154-b Tule Creek Road Hayfork CA 96041 Ph: (530) 628-4111 |
| NPI Number | 1871795492 |
|---|---|
| Provider Enumeration Date | 06/05/2007 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871795492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5318 (California) | Primary |