Provider Demographics
NPI:1104561257
Name:MINISTERIAL ASSOCIATION OF COLUSA COUNTY
Entity type:Organization
Organization Name:MINISTERIAL ASSOCIATION OF COLUSA COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMULLAN
Authorized Official - Suffix:
Authorized Official - Credentials:REV
Authorized Official - Phone:530-419-9584
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-0674
Mailing Address - Country:US
Mailing Address - Phone:530-473-9050
Mailing Address - Fax:
Practice Address - Street 1:241 5TH ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2410
Practice Address - Country:US
Practice Address - Phone:530-473-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251X00000XAgenciesSupports Brokerage
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty