Provider Demographics
NPI:1194559484
Name:COUNTY OF TULARE
Entity type:Organization
Organization Name:COUNTY OF TULARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HHS DEPUTY DIRECTOR, IS
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-623-0101
Mailing Address - Street 1:5957 S MOONEY BLVD
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9394
Mailing Address - Country:US
Mailing Address - Phone:559-623-0101
Mailing Address - Fax:
Practice Address - Street 1:5957 S MOONEY BLVD
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-9394
Practice Address - Country:US
Practice Address - Phone:559-623-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF TULARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-28
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty