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General NPI Number Information
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NPI Number | 1295548691
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VALLEY CHILD AND FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 550 HARVEST PARK SUITE B
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City | BRENTWOOD
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State | CA
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Zip | 94513
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Country | US
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Telephone | 530-265-9057
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Fax |
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Provider Business Mailing Address
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Address Line | 24077 ST HWY 49
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City | NEVADA CITY
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State | CA
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Zip | 95959
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Country | US
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Telephone | 530-265-9057
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Fax | 530-292-3803
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Authorized Official
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Title or Position | DIRECTOR
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Name | TERESA PETRIE
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Credential |
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Telephone | 530-265-9057
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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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