Organization
DEPARTMENT OF HEALTH SERVICES - MENTAL HEALTH
Active
Parent organization
DEPARTMENT OF HEALTH
Other names
Community Mental Health Center-Cloverdale Regional Satelitte
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEPARTMENT OF HEALTH
Authorized official
DIANA L STORNETTA (COMPLIANCE ACCOUNTANT III)
(707) 565-4782
Entity
Organization
Contact information
Practice address
100 W 3RD ST, CLOVERDALE, CA 95425-3204
(187) 770-0527
Mailing address
100 W 3RD ST, CLOVERDALE, CA 95425-3204
(187) 770-0527
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49CC1
CA STATE MEDI-CAL RU
CA
Enumeration date
02/08/2008
Last updated
02/08/2008
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