| Icps | |
|
1445 Bunyan Rd Suite B Susanville CA 96130-3201 | |
| (530) 251-8277 | |
| Not Available |
| Full Name | Icps |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1445 Bunyan Rd, Susanville, California |
| Authorized Official Name and Position | Terri O'bryan (DIRECTOR) |
| Authorized Official Contact | 5302512653 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icps 1445 Bunyan Rd Suite B Susanville CA 96130-3201 Ph: (530) 251-8277 | Icps 1445 Bunyan Rd Suite B Susanville CA 96130-3201 Ph: (530) 251-8277 |
| NPI Number | 1306083928 |
|---|---|
| Provider Enumeration Date | 01/20/2009 |
| Last Update Date | 01/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306083928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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