Organization
ALPINE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA KNORR (CHIEF ADMINISTRATIVE OFFICER)
(530) 694-2287
Entity
Organization
Contact information
Practice address
75 DIAMOND VALLEY RD, UNIT C, MARKLEEVILLE, CA 96120-9532
(530) 694-1816
Mailing address
PO BOX 217, MARKLEEVILLE, CA 96120-0217
(530) 694-2287
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000226
—
CA
Enumeration date
05/27/2010
Last updated
03/24/2020
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