Organization
COUNTY OF MENDOCINO
Active
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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