Organization
MENDOCINO COAST HOSPITALITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA CLARE SHAW (EXECUTIVE DIRECTOR)
(707) 961-0172
Entity
Organization
Contact information
Practice address
137 E. OAK STREET, FORT BRAGG, CA 95437
(707) 961-0172
(844) 388-6167
Mailing address
P.O. BOX 2168, FORT BRAGG, CA 95437
(707) 961-0172
(844) 388-6167
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LMFT92510
CA
Other
Enumeration date
10/19/2016
Last updated
02/24/2017
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