Healthcare Provider Details

I. General information

NPI: 1386025971
Provider Name (Legal Business Name): COUNTY OF MADERA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N R ST
MADERA CA
93637-4465
US

IV. Provider business mailing address

PO BOX 1288
MADERA CA
93639-1288
US

V. Phone/Fax

Practice location:
  • Phone: 559-673-3508
  • Fax: 559-675-4999
Mailing address:
  • Phone: 559-395-0451
  • Fax: 559-675-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. EVA WEIKEL
Title or Position: DIVISION MANAGER
Credential:
Phone: 559-395-0451