Healthcare Provider Details

I. General information

NPI: 1073382842
Provider Name (Legal Business Name): OROVILLE RESCUE MISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4248 LINCOLN BLVD
OROVILLE CA
95966-6765
US

IV. Provider business mailing address

PO BOX 2481
OROVILLE CA
95965-2481
US

V. Phone/Fax

Practice location:
  • Phone: 530-533-9120
  • Fax:
Mailing address:
  • Phone: 530-533-9120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ALLAN DIKES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 530-533-9120