Organization
MISSION PROVIDER SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANA EMERSON (EXECUTIVE DIRECTOR)
(530) 222-5633
Entity
Organization
Contact information
Practice address
3810 CANTERBURY DR, REDDING, CA 96002-4888
(530) 221-2236
(530) 222-5528
Mailing address
2970 INNSBRUCK DR, STE C, REDDING, CA 96003-9303
(530) 222-5633
(530) 222-5528
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
230000307
CA
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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