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General NPI Number Information
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NPI Number | 1720856743
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Entity Type | Organization
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Legal Business Name | HUMBOLDT COMMUNITY ACCESS AND RESOURCE CENTER
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 1707 E ST STE 2
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City | EUREKA
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State | CA
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Zip | 95501-7621
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Country | US
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Telephone | 707-443-7077
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Fax |
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Provider Business Mailing Address
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Address Line | 1707 E ST STE 2
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City | EUREKA
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State | CA
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Zip | 95501-7621
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Country | US
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Telephone | 707-443-7077
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | PENNIE SUE LOCKLIN-LEE
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Credential |
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Telephone | 707-443-7077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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