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NPI 1265640288

NPI 1265640288 : HUMBOLDT COUNTY BEHAVIORAL HEALTH : EUREKA, CA

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General NPI Number Information
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    NPI Number           |    1265640288
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    Entity Type          |    Organization 
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    Legal Business Name  |    HUMBOLDT COUNTY BEHAVIORAL HEALTH 
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Dates
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    Enumeration Date     |    05/21/2007
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    Last Update Date     |    09/13/2023
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Provider Practice Location Address
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    Address Line         |    2910 H ST 
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    City                 |    EUREKA
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    State                |    CA
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    Zip                  |    95501-4408
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    Country              |    US
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    Telephone            |    707-268-2990
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    720 WOOD ST 
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    City                 |    EUREKA
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    State                |    CA
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    Zip                  |    95501-4413
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    Country              |    US
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    Telephone            |    707-268-2990
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MENTAL HEALTH BRANCH DIRECTOR
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    Name                 |     EMI  BOTZLER-ROGERS 
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    Credential           |    MFT
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    Telephone            |    707-268-2990
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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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