Organization
COUNTY OF MENDOCINO
Active
Other names
AODP
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA GUNTLY (PROGRAM DIRECTOR)
(707) 472-2607
Entity
Organization
Contact information
Practice address
221 S LENORE AVE, WILLITS, CA 95490-3632
(707) 456-3821
Mailing address
221 S LENORE AVE, WILLITS, CA 95490-3632
(707) 456-3821
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2302
DRUG MEDICAL WILLITS
CA
Enumeration date
01/29/2007
Last updated
09/11/2025
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