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General NPI Number Information
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NPI Number | 1457765166
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Entity Type | Organization
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Legal Business Name | COMMUNITY POOL FOR THE HANDICAPPED, INC.
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 06/20/2014
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Provider Practice Location Address
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Address Line | 144 GIBSON AVE
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City | YUBA CITY
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State | CA
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Zip | 95991-5513
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Country | US
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Telephone | 530-671-4373
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Fax | 530-671-4352
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Provider Business Mailing Address
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Address Line | 144 GIBSON AVE
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City | YUBA CITY
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State | CA
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Zip | 95991-5513
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Country | US
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Telephone | 530-671-4373
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Fax | 530-671-4352
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CYNTHIA LEE RODERICK
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Credential |
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Telephone | 530-671-4373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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