Organization
NEVADA COUNTY CCS
Active
Other names
Champion Mine School MTU
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE LITTON (CMS COORDINATOR)
(530) 265-1450
Entity
Organization
Contact information
Practice address
400 HOOVER LN, NEVADA CITY, CA 95959-2944
(530) 265-0618
(530) 265-0524
Mailing address
500 CROWN POINT CIR, SUITE 110, GRASS VALLEY, CA 95945-9514
(530) 265-1450
(530) 271-0841
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CCS00002F
—
CA
Enumeration date
01/18/2007
Last updated
08/22/2020
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