Organization · NPI-2

Crisis Intervention Specialist

Clinic/Center, Mental Health (Including Community Mental Health Center) · Roseville, CA

NPI number1063545531
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1063545531
Entity type
Organization (NPI-2)
Legal business name
Crisis Intervention Specialist
Organization subpart
No
Enumeration date
Mar 14, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

101 Cirby Hills Dr
Roseville, CA 95678-4360

Phone 530-401-3894

Mailing address

10585 Sierra Estates Dr
Auburn, CA 95602-9401

Phone 530-401-3894

Authorized official

Jeffrey Grant Adorador
Crisis Counselor
5304013894

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