Organization
EL DORADO COUNTY CCS
Active
Other names
South Lake Tahoe MTU
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAYLE ERBE-HAMLIN (PUBLIC HEALTH DIRECTOR)
(530) 621-6191
Entity
Organization
Contact information
Practice address
1100 LYONS AVE, SOUTH LAKE TAHOE, CA 96150-8252
(530) 543-2313
(530) 543-2275
Mailing address
931 SPRING ST, PLACERVILLE, CA 95667-4543
(530) 621-6128
(530) 622-5109
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CCS00108F
—
CA
Enumeration date
03/14/2007
Last updated
08/22/2020
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