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General NPI Number Information
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NPI Number | 1619191962
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Entity Type | Organization
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Legal Business Name | MADERA COUNTY BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 49774 ROAD 426 SUITE D
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City | OAKHURST
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State | CA
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Zip | 93644-8690
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Country | US
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Telephone | 559-683-4809
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Fax | 559-683-6499
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | OAKHURST
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State | CA
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Zip | 93644-0100
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Country | US
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Telephone | 559-642-6872
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Fax |
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Authorized Official
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Title or Position | CERTIFIED ALCOHOL DRUG COUNSELOR
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Name | MR. LEONARD STEVEN SAMORA
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Credential | FACT 242
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Telephone | 559-683-4809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | FACT 242
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License Number State | CA
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