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General NPI Number Information
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NPI Number | 1912147851
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Entity Type | Organization
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Legal Business Name | SOUTH TULARE COUNTY MOBILE UNIT
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 201 N K ST
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City | TULARE
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State | CA
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Zip | 93274-4005
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Country | US
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Telephone | 559-687-0929
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Fax | 559-685-8953
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Provider Business Mailing Address
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Address Line | 201 N K ST
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City | TULARE
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State | CA
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Zip | 93274-4005
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Country | US
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Telephone | 559-687-0929
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Fax | 559-685-8953
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Authorized Official
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Title or Position | CASE MANAGER 1
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Name | MS. MICHELLE ANN HERRERA
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Credential |
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Telephone | 559-687-0929
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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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