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General NPI Number Information
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NPI Number | 1831245802
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Entity Type | Organization
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Legal Business Name | BUTTE GLENN COMMUNITY COLLEGE DISTRICT
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3536 BUTTE CAMPUS DRIVE
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City | OROVILLE
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State | CA
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Zip | 95965-8399
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Country | US
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Telephone | 530-895-2441
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Fax | 530-895-2846
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Provider Business Mailing Address
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Address Line | 3536 BUTTE CAMPUS DRIVE
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City | OROVILLE
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State | CA
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Zip | 95965-8399
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Country | US
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Telephone | 530-895-2441
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Fax | 530-895-2846
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Authorized Official
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Title or Position | VICE PRESIDENT OF ADMINISTRATION
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Name | MR. ANDY SULESKI
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Credential |
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Telephone | 530-895-2353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A22866
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License Number State | CA
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