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Organization

COUNTY OF MENDOCINO

Active
Parent organization
COUNTY OF MENDOCINO
Other names
Behavioral Health & Recovery Services - Mental Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
COUNTY OF MENDOCINO
Authorized official
DR. JENINE MILLER PSY.D. (BHRS DIRECTOR)
(707) 472-2341
Entity
Organization

Contact information

Practice address
1120 S DORA ST, UKIAH, CA 95482-3919
(707) 463-4303
Mailing address
1120 S DORA ST, UKIAH, CA 95482-6340
(707) 472-2300

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
302F00000X
Exclusive Provider Organization

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00023
MH COUNTY MEDICAL INDENTI
CA
01
2315
MEDICAL PROVIDER #
CA
05
2315
CA
01
BBB33295B
MH SUBMITTER NUMBER
CA
Enumeration date
01/25/2007
Last updated
12/02/2023
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