MEDICARE: COUNTY OF NEVADA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	00G775570	CA
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1982620399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF NEVADA

Provider Business Mailing Address
First Line	:	500 CROWN POINT CIR STE 120
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-9561
Country	:	US
Telephone Number	:	530-265-1437
Fax Number	:	530-271-0257

Provider Business Practice Location Address
First Line	:	500 CROWN POINT CIR STE 120
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-9561
Country	:	US
Telephone Number	:	530-265-1437
Fax Number	:	530-271-0257

Authorized Official
Title or Position	:	DIRECTOR
Name	:	PHEBE BELL
Credential	:	MSW
Telephone Number	:	530-470-2784

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	12/20/2023

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Directions to “COUNTY OF NEVADA ” Practice Location

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