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General NPI Number Information
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NPI Number | 1093850273
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Entity Type | Organization
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Legal Business Name | COUNTY OF MADERA
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 209 E 7TH ST
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City | MADERA
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State | CA
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Zip | 93638-3780
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Country | US
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Telephone | 559-673-3508
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Fax | 559-675-4999
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Provider Business Mailing Address
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Address Line | PO BOX 1288
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City | MADERA
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State | CA
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Zip | 93639-1288
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Country | US
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Telephone | 559-673-3508
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Fax | 559-675-4999
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Authorized Official
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Title or Position | DIRECTOR BEHAVIORAL HEALTH SERVICES
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Name | DENNIS P KOCH
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Credential | MPA
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Telephone | 559-673-3508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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