County of Lake
NPI #1578861761 in Lower Lake, California
Provider Information
- NPI Number
- 1578861761
- Entity Type
- Organization
- Organization Name
- County of Lake
- Primary Specialty
- Clinic/Center - Rehabilitation, Substance Use Disorder
- Enumeration Date
- Mar 11, 2011
- Last Updated
- Aug 26, 2024
Practice Location
- Address
- 9345 WINCHESTER ST
- City
- Lower Lake
- State
- California
- ZIP Code
- 95457-5000
- Phone
- (707) 994-6494
Authorized Official
- Name
- KRISTY KELLY, MFT
- Title
- DEPARTMENT HEAD
- Phone
- (707) 263-4338
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
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