Organization
COUNTY OF SACRAMENTO
Active
Other names
Revere Mental Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
UMA ZYKOFSKY (DEPUTY DIRECTOR)
(916) 875-7070
Entity
Organization
Contact information
Practice address
776 REVERE ST, SACRAMENTO, CA 95818-2022
(916) 874-9140
(916) 874-9132
Mailing address
7001A EAST PKWY, SUITE 400, SACRAMENTO, CA 95823-2501
(916) 875-4948
(916) 875-6970
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8461
—
CA
Enumeration date
11/26/2006
Last updated
09/25/2014
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