Provider Demographics
NPI:1679879787
Name:LASSEN COUNTY COMMUNITY SOCIAL SERVICES
Entity type:Organization
Organization Name:LASSEN COUNTY COMMUNITY SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-251-8336
Mailing Address - Street 1:1616 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-3720
Mailing Address - Country:US
Mailing Address - Phone:530-251-8336
Mailing Address - Fax:530-251-8336
Practice Address - Street 1:1616 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-3720
Practice Address - Country:US
Practice Address - Phone:530-251-8128
Practice Address - Fax:530-251-2668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty