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El Dorado County Ccs
Rehabilitation Clinic/Center in South Lake Tahoe, California
NPI 1730212937

El Dorado County Ccs is a Rehabilitation Clinic/Center based in Placerville, CA and is specialized in Rehabilitation. El Dorado County Ccs practices in South Lake Tahoe, CA. The NPI Number for El Dorado County Ccs is 1730212937 and holds a License No. (California).

The current practice location address for El Dorado County Ccs is 1100 Lyons Ave, South Lake Tahoe, CA and can be reached out via phone at 530-543-2313 and via fax at 530-543-2275.

Location: 1100 Lyons Ave, South Lake Tahoe, CA, 95667-4543
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1730212937
Provider Name
El Dorado County Ccs
Credential
Provider Entity Type
Organization
Address
1100 Lyons Ave, South Lake Tahoe, CA, 95667-4543
Phone Number
530-543-2313
Fax Number
530-543-2275
Provider Enumeration Date
03/14/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CCS00108F 05 CA
institution
Provider Business Practice Location Address Details
Address
1100 Lyons Ave
City
South Lake Tahoe
State
California
Zip
96150-8252
Phone Number
530-543-2313
Fax Number
530-543-2275
person
Provider Business Mailing Address Details
Address
1100 Lyons Ave
City
South Lake Tahoe
State
California
Zip
96150-8252
Phone Number
530-543-2313
Fax Number
530-543-2275
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation
Taxonomy
261QR0400X
License No.
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Definition
Definition to come...
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