Provider Demographics
NPI:1871795492
Name:TRINITY COUNTY
Entity type:Organization
Organization Name:TRINITY COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-623-8293
Mailing Address - Street 1:P.O. BOX 91
Mailing Address - Street 2:
Mailing Address - City:HAYFORK
Mailing Address - State:CA
Mailing Address - Zip Code:96041
Mailing Address - Country:US
Mailing Address - Phone:530-628-4111
Mailing Address - Fax:
Practice Address - Street 1:154-B TULE CREEK ROAD
Practice Address - Street 2:
Practice Address - City:HAYFORK
Practice Address - State:CA
Practice Address - Zip Code:96041
Practice Address - Country:US
Practice Address - Phone:530-628-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY COUNTY BEHAVIORAL HEALTH SERVICES - HYFK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-05
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5318251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health