Provider Demographics
NPI:1912147851
Name:SOUTH TULARE COUNTY MOBILE UNIT
Entity type:Organization
Organization Name:SOUTH TULARE COUNTY MOBILE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER 1
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-687-0929
Mailing Address - Street 1:201 N K ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-4005
Mailing Address - Country:US
Mailing Address - Phone:559-687-0929
Mailing Address - Fax:559-685-8953
Practice Address - Street 1:201 N K ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-4005
Practice Address - Country:US
Practice Address - Phone:559-687-0929
Practice Address - Fax:559-685-8953
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINGSVIEW CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management