NPIMap

Organization Active NPI

Humboldt County Mental Health

Doing business as Pine Grove Program

  • Community/Behavioral Health Agency
  • Eureka, CA
National Provider Identifier
1700904547
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HUMBOLDT COUNTY MENTAL HEALTH
Doing business as
Pine Grove Program
Practice address
674 Allard Ave
Eureka, CA 95503-5857
Phone
(707) 268-2900
NPI assigned
Mar 27, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donna Wheeler, LCSWNPI 1699818435
Title
Mental Health Director
Phone
(707) 268-2990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

674 Allard Ave
Eureka, CA 95503-5857

Mailing address

720 Wood St
Eureka, CA 95501-4413
Phone (707) 268-2990

Other identifiers 1

IdentifierTypeStateIssuer
000001228MedicaidCA

Other names 1

  • Pine Grove Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Humboldt County Mental35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Locations

674 Allard Ave
Eureka, CA 95503
Phone (707) 268-2900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1700904547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WOOD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014413",
            "telephone_number": "707-268-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "674 ALLARD AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955035857",
            "telephone_number": "707-268-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT COUNTY MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "MENTAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "707-268-2990",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001228",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Grove Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.