Organization
HUMBOLDT SENIOR RESOURCE CENTER
Active
Other names
Fortuna Adult Day Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA HOOVEN (CHIEF EXECUTIVE OFFICER)
(707) 443-9747
Entity
Organization
Contact information
Practice address
3200 NEWBURG ROAD, FORTUNA, CA 95540-2511
(707) 443-9747
(707) 443-3498
Mailing address
1910 CALIFORNIA ST, EUREKA, CA 95501-2870
(707) 725-6927
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
ADU70071F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ADU70071F
—
CA
Enumeration date
05/03/2007
Last updated
05/22/2020
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