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General NPI Number Information
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NPI Number | 1962759522
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Entity Type | Organization
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Legal Business Name | CALAVERAS COUNTY
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 590 TOYANZA DRIVE
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City | SAN ANDREAS
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State | CA
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Zip | 95249
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Country | US
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Telephone | 209-754-6516
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Fax |
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Provider Business Mailing Address
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Address Line | 891 MOUNTAIN RANCH RD
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City | SAN ANDREAS
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State | CA
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Zip | 95249-9713
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | STACEY MEILY
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Credential |
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Telephone | 209-754-6516
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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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