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General NPI Number Information
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NPI Number | 1679691315
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Entity Type | Organization
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Legal Business Name | HUMBOLDT COUNTY MENTAL HEALTH
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 06/12/2017
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Provider Practice Location Address
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Address Line | 2004 HARRISON AVE
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City | EUREKA
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State | CA
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Zip | 95501-3212
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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 DIRECTOR
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Name | DONNA WHEELER
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Credential | LCSW
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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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