Healthcare Provider Details

I. General information

NPI: 1114761699
Provider Name (Legal Business Name): POOR AND THE HOMELESS TEHAMA COUNTY COALITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 LAY AVE
RED BLUFF CA
96080-9849
US

IV. Provider business mailing address

PO BOX 315
RED BLUFF CA
96080-0315
US

V. Phone/Fax

Practice location:
  • Phone: 530-727-9291
  • Fax:
Mailing address:
  • Phone: 530-727-9336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: HALEY SURTEES
Title or Position: DIRECTOR OF ADMINISTRATION
Credential:
Phone: 530-200-0332