Organization
COUNTY OF MENDOCINO
Active
Other names
Substance Use Disorders Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
JENINE MILLER PAY.D. (DIRECTOR)
(707) 472-2341
Entity
Organization
Contact information
Practice address
1120 S DORA ST, UKIAH, CA 95482-6340
(707) 472-2637
(707) 472-2657
Mailing address
1120 S DORA ST, UKIAH, CA 95482-6340
(707) 472-2637
(707) 472-2657
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
261QP0905X
State or Local Public Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305
UKIAH DRUG MEDICAL #
CA
Enumeration date
01/31/2007
Last updated
04/14/2025
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