ROUND VALLEY INDIAN HEALTH CENTER NPI 1114136066

NPI Information

NPI: 1114136066
Provider Name: ROUND VALLEY INDIAN HEALTH CENTER

Other Name: YUKI TRAILS HUMAN SERVICES DEPARTMENT

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
23000 HENDERSON LANE
COVELO, CA
ZIP 95428
Phone: (707) 983-6404
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ROUND VALLEY INDIAN HEALTH CENTER is a mental health (including community mental health center) clinic center in Covelo, CA. ROUND VALLEY INDIAN HEALTH CENTER NPI is 1114136066. The provider is registered as an organization entity type.
The provider Other Name Is Yuki Trails Human Services Department.

The provider's business location address is:

23000 HENDERSON LANE
COVELO, CA
ZIP 95428-247
Phone: (707) 983-6404
Fax: (707) 983-6184

The provider's authorized official is Otis Brotherton .
The authorized official title is Executive Director and has the following contact phone number (707) 983-6404.

The enumeration date for this NPI number is 5/21/2007 and was last updated on 3/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	230007AN	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	THP11697F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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