NPIMap

Organization Active NPI

Mendocino Coast Hospitality Center

  • Community/Behavioral Health Agency
  • Fort Bragg, CA
National Provider Identifier
1902357437
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LMFT92510 Issued in CA
Legal business name
MENDOCINO COAST HOSPITALITY CENTER
Practice address
137 E. Oak Street
Fort Bragg, CA 95437
Phone
(707) 961-0172
Fax
(844) 388-6167
NPI assigned
Oct 19, 2016
Last updated
Feb 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Authorized official

Name
Anna Clare ShawNPI 1164836961
Title
Executive Director
Phone
(707) 961-0172

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LMFT92510 CA Primary

Addresses

Primary practice location

137 E. Oak Street
Fort Bragg, CA 95437

Mailing address

P.O. Box 2168
Fort Bragg, CA 95437
Phone (707) 961-0172

National Provider Directory

National Provider Directory
Tax ID family
Hospitality Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

137 E Oak St
Fort Bragg, CA 95437
Phone (707) 345-4012

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1902357437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2168",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-961-0172",
            "fax_number": "844-388-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 E. OAK STREET",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-961-0172",
            "fax_number": "844-388-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDOCINO COAST HOSPITALITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "CLARE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-961-0172"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "LMFT92510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.