Healthcare Provider Details

I. General information

NPI: 1942852900
Provider Name (Legal Business Name): PLUMAS COUNTY ALCOHOL AND DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 COUNTY HOSPITAL RD STE 109
QUINCY CA
95971-9173
US

IV. Provider business mailing address

270 COUNTY HOSPITAL RD STE 127
QUINCY CA
95971-9174
US

V. Phone/Fax

Practice location:
  • Phone: 530-283-6307
  • Fax: 530-283-6045
Mailing address:
  • Phone: 530-283-6307
  • Fax: 530-283-6045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA R MCGILL
Title or Position: QAQI MANAGER
Credential:
Phone: 530-283-6307