Organization
SHASTA COUNTY ALCOHOL AND DRUG PROGRAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE HANNIGAN (SENIOR STAFF ANALYST)
(530) 245-6419
Entity
Organization
Contact information
Practice address
2640 BRESLAUER WAY, REDDING, CA 96001-4246
(530) 245-6419
(530) 225-5232
Mailing address
2640 BRESLAUER WAY, REDDING, CA 96001-4246
(530) 225-5240
(530) 225-5232
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
4516
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4516
DRUG MEDI-CAL PROVIDER #
CA
Enumeration date
10/06/2006
Last updated
08/22/2020
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