Organization
COUNTY OF LAKE
Active
Organization
COUNTY OF LAKE
Active
Parent organization
COUNTY OF LAKE
Other names
Big Oak Peer Support Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF LAKE
Authorized official
ELISE JONES MA (DIRECTOR)
(707) 274-9101
Entity
Organization
Contact information
Practice address
13300 E HIGHWAY 20 STE O, CLEARLAKE OAKS, CA 95423-9436
(707) 998-0310
Mailing address
PO BOX 1024, LUCERNE, CA 95458-1024
(707) 998-0310
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17EZ
—
CA
Enumeration date
05/29/2024
Last updated
08/26/2024
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