1225432370 NPI number — NAPA COUNTY HEALTH AND HUMAN SERVICES

Table of content: (NPI 1225432370)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225432370 NPI number — NAPA COUNTY HEALTH AND HUMAN SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NAPA COUNTY HEALTH AND HUMAN SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CLINIC OLE CALISTOGA - NAPA COUNTY ALCOHOL AND DRUG SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225432370
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2261 ELM ST
Provider Second Line Business Mailing Address:
HHSA - FISCAL
Provider Business Mailing Address City Name:
NAPA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94559-3721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-253-4662
Provider Business Mailing Address Fax Number:
707-253-4766

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
911 WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALISTOGA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94515-1433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-253-4662
Provider Business Practice Location Address Fax Number:
707-253-4766
Provider Enumeration Date:
10/17/2014

Additional Information

Authorized Official

Authorized Official Last Name:
HIMES
Authorized Official First Name:
HOWARD
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
707-253-4279

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2840028 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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