South Lake Tahoe Mtu

LBN: El Dorado County Ccs
South Lake Tahoe Mtu is an health care organization with primary practice located at 1100 Lyons Ave , South Lake Tahoe CA 96150-8252. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, which is considered as the primary health care specialty. El Dorado County Ccs can be contacted via phone (530) 543-2313, or through Erbe-Hamlin, Gayle via phone (530) 621-6191.

Contact Information

Primary practice address
1100 Lyons Ave South Lake Tahoe CA 96150-8252
Phone: (530) 543-2313
Fax: (530) 543-2275
Website:
Map and Directions
Authorized official contact:
Name: Erbe-Hamlin, Gayle
Phone: (530) 621-6191

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X

Profile Details

NPI number 1730212937
LBN Legal business name El Dorado County Ccs
DBA Doing business as South Lake Tahoe Mtu
Authorized official Erbe-Hamlin, Gayle
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730212937 NPPES
California MEDICAID CCS00108F

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