Provider Demographics
NPI:1316710460
Name:HUMBOLDT COUNTY CHILDREN AND FAMILIES COMMISSION
Entity type:Organization
Organization Name:HUMBOLDT COUNTY CHILDREN AND FAMILIES COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-445-7389
Mailing Address - Street 1:325 2ND ST STE 201
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0589
Mailing Address - Country:US
Mailing Address - Phone:707-445-7389
Mailing Address - Fax:
Practice Address - Street 1:325 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0589
Practice Address - Country:US
Practice Address - Phone:707-445-7389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty