Healthcare Provider Details

I. General information

NPI: 1881322659
Provider Name (Legal Business Name): LASSEN FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 RIVERSIDE DR
SUSANVILLE CA
96130-4432
US

IV. Provider business mailing address

PO BOX 710
SUSANVILLE CA
96130-0710
US

V. Phone/Fax

Practice location:
  • Phone: 530-257-4599
  • Fax:
Mailing address:
  • Phone: 530-257-5466
  • Fax: 530-257-5490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: BOBBIE ORMACHEA
Title or Position: FISCAL DIRECTOR
Credential:
Phone: 530-257-5466