Healthcare Provider Details

I. General information

NPI: 1518605252
Provider Name (Legal Business Name): ARCATA HOUSE PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 11TH ST
ARCATA CA
95521-5502
US

IV. Provider business mailing address

1005 11TH ST
ARCATA CA
95521-5502
US

V. Phone/Fax

Practice location:
  • Phone: 707-822-4528
  • Fax:
Mailing address:
  • Phone: 707-822-4528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. DARLENE SPOOR
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 707-822-4528