Healthcare Provider Details

I. General information

NPI: 1326318080
Provider Name (Legal Business Name): LASSEN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HWY 299 EAST
BIEBER CA
96009
US

IV. Provider business mailing address

PO BOX 40
BIEBER CA
96009-0040
US

V. Phone/Fax

Practice location:
  • Phone: 530-294-5700
  • Fax: 530-294-5701
Mailing address:
  • Phone: 530-294-5700
  • Fax: 530-294-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KEVIN MANNEL
Title or Position: DEPUTY COUNTY ADMINISTRATIVE OFFICE
Credential:
Phone: 530-251-8112