Healthcare Provider Details

I. General information

NPI: 1548681570
Provider Name (Legal Business Name): HSRC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2013
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 CALIFORNIA ST
EUREKA CA
95501-2809
US

IV. Provider business mailing address

1910 CALIFORNIA ST
EUREKA CA
95501-2870
US

V. Phone/Fax

Practice location:
  • Phone: 707-443-9747
  • Fax: 707-443-3498
Mailing address:
  • Phone: 707-443-9747
  • Fax: 707-443-3498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JOYCE A HAYES
Title or Position: EXECUTIVE OFFICER
Credential: RDMS
Phone: 707-443-9747