| NPI | 1750010344 |
|---|---|
| Doing Business As | JUVENILE HALL |
| Entity Type | Organization |
| Authorized Contact | JEFFERY BRANDON THORNOCK CEO 530-246-5710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| 207QA0000X Family Medicine, Adolescent Medicine | |
| 208000000X Pediatrics | |
| 261QD0000X Clinic/Center, Dental | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2024-10-16 |