Organization
COUNTY OF MENDOCINO
Active
Other names
Substance Use Disorders Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
JENINE MILLER PSY.D. (BHRS DEPUTY DIRECTOR)
(707) 472-2637
Entity
Organization
Contact information
Practice address
727 S. STATE STREET, UKIAH, CA 95482-5815
(707) 472-2637
(707) 472-2657
Mailing address
1120 S. DORA STREET, UKIAH, CA 95482-6340
(707) 472-2637
(707) 472-2657
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTHER
OTHER
—
Enumeration date
03/11/2014
Last updated
07/01/2014
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