# EL DORADO COUNTY CCS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Lake Tahoe MTU
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730212937
- **Authorized official:** MS. GAYLE ERBE-HAMLIN (PUBLIC HEALTH DIRECTOR)
- **Authorized official phone:** (530) 621-6191

## Contact information

- **Practice address:** 1100 LYONS AVE, SOUTH LAKE TAHOE, CA 96150-8252
- **Practice address phone:** (530) 543-2313
- **Practice address fax:** (530) 543-2275
- **Mailing address:** 931 SPRING ST, PLACERVILLE, CA 95667-4543
- **Mailing address phone:** (530) 621-6128
- **Mailing address fax:** (530) 622-5109

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 08/22/2020