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Organization
ROUND VALLEY INDIAN HEALTH CENTER
Active
Organization
ROUND VALLEY INDIAN HEALTH CENTER
Active
Other names
Yuki Trails Human Services Department
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OTIS BROTHERTON (EXECUTIVE DIRECTOR)
(707) 983-6404
Entity
Organization
Contact information
Practice address
23000 HENDERSON LANE, COVELO, CA 95428-0247
(707) 983-6404
(707) 983-6184
Mailing address
PO BOX 247, COVELO, CA 95428-0247
(707) 983-6404
(707) 983-6184
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
230007AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THP11697F
—
CA
Enumeration date
05/21/2007
Last updated
03/13/2024
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