Provider Demographics
NPI:1699321752
Name:COUNTY OF AMADOR
Entity type:Organization
Organization Name:COUNTY OF AMADOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:209-223-6412
Mailing Address - Street 1:10877 CONDUCTOR BLVD SUITE 300 ROOM 324
Mailing Address - Street 2:
Mailing Address - City:SUTTER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95685
Mailing Address - Country:US
Mailing Address - Phone:209-223-6413
Mailing Address - Fax:
Practice Address - Street 1:10877 CONDUCTOR BLVD SUITE 300 ROOM 324
Practice Address - Street 2:
Practice Address - City:SUTTER CREEK
Practice Address - State:CA
Practice Address - Zip Code:95685
Practice Address - Country:US
Practice Address - Phone:209-223-6413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF AMADOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder