SI SF02003.001 State Interim Assistance (IA) Agencies (TN 2 – 04/2007)

A. Arizona – Participating Agency’s Payee, Address and GR Code:

PARTICIPATING AGENCYS PAYEE AND ADDRESS

GR CODE

DEPT ECONOMIC SECURITY

OARC – 833C

PO BOX 60

PHOENIX AZ 85001-0060

03060

B. California - Participating Agencies’ Payees, Addresses and GR Codes:

COUNTY

PARTICIPATING AGENCYS PAYEE AND ADDRESS

GR CODE

ALAMEDA

ALAMEDA COUNTY

SOC SERVICES AGENCY

PO BOX 2094-S775

OAKLAND CA 94604-2094

05000

HEALTH CARE AGENCY

SUBSTITUTE PAYEE IAR

P O BOX 129

SAN LEANDRO CA 94577-0929

05001

ALPINE

ALPINE COUNTY

AUDITOR

P O BOX 266

MARKLEEVILLE CA 96120-0266

05010

AMADOR

AMADOR COUNTY DSS

10877 CONDUCTOR BLVD

SUITE 200

SUTTER CREEK CA 95685

05020

BUTTE

BUTTE COUNTY

DEPT SOCIAL WELFARE

P O BOX 1649

OROVILLE CA 95965-1649

05030

BUTTE COUNTY MNTL

TREASURER

25 COUNTY CENTER DR

OROVILLE CA 95965-3316

05031

CALAVERAS

CALAVERAS COUNTY

SOCIAL WELFARE

891 MOUNTAIN RANCH RD

SAN ANDREAS CA 95249-9713

05040

COLUSA

COLUSA COUNTY

HEALTH AND HUMAN SVCS

251 E. WEBSTER ST

COLUSA CA 95932-0370 95932-0370

05050

CONTRA COSTA

CONTRA COSTA COUNTY

AUDITOR CONTROLLER

625 COURT STREET

MARTINEZ CA 94553-1231

05060

CONTRA COSTA COUNTY

MENTAL HEALTH

625 COURT ST RM 205

MARTINEZ CA 94553-1231

05061

DEL NORTE

DEL NORTE COUNTY

DEPT SOCIAL SERVICES

880 NORTHCREST DR

CRESCENT CITY CA 95531-3419

05070

DEL NORTE COUNTY

MENTAL HEALTH SERVICES

PO BOX E

CRESCENT CITY CA 95531-0015

05071

EL DORADO

EL DORADO COUNTY

WELFARE DEPARTMENT

3057 BRIW RD

PLACERVILLE CA 95667

05080

EL DORADO COUNTY

MENTAL HEALTH

670 PLACERVILLE DR #1B

PLACERVILLE CA 95667-3920

05081

FRESNO

FRESNO COUNTY

DEP SOCIAL SERVICES

P O BOX 1912

FRESNO CA 93718-1912

05090

FRESNO COUNTY

MENTAL HEALTH

1221 FULTON MALL

FRESNO CA 93721-1915

05091

GLENN

GLENN COUNTY

SOCIAL SERVICES

P O BOX 611

WILLOWS CA 95988-0611

05100

GLENN COUNTY

MNTL HLTH LIFE SUPPORT

242 NORTH VILLA AVE

WILLOWS CA 95988-2641

05101

HUMBOLDT

HUMBOLDT COUNTY

PUBLIC WELFARE

929 KOSTER

EUREKA CA 95501-0106

05110

HUMBOLDT COUNTY

MENTAL HEALTH

720 WOOD ST

EUREKA CA 95501-4413

05111

IMPERIAL

IMPERIAL COUNTY

DEPT OF SOCIAL SERV

STE 104 2995 S 4TH ST

EL CENTRO CA 92243

05120

INYO

INYO COUNTY

SOCIAL SERVICES

P O BOX A

INDEPENDENCE CA 93526-0601

05130

KERN

KERN COUNTY

HUMAN SERVICES

P O BOX 511

BAKERSFIELD CA 93302-0511

05140

KERN CO MENTAL HEALTH

ATTN COLLECTIONS

P O BOX 1000

BAKERSFIELD CA 93302

05141

KINGS

KINGS COUNTY DPSS

KINGS CTY GOVT CENTER

1200 SOUTH DRIVE

HANFORD CA 93230-5341

05150

LAKE

LAKE COUNTY

AUDITOR/CONTROLLER

255 N FORBES ST

LAKEPORT CA 95453-4731

05160

LASSEN

LASSEN COUNTY

HEALTH HUMAN SERVICES

P O BOX 1359

SUSANVILLE CA 96130-1359

05170

LOS ANGELES

DPSS CASHIER A/O

PO BOX 512180

LOS ANGELES CA 90051-0180

05200

DEPT OF MENTAL HEALTH

P O BOX 512168

LOS ANGELES CA 90051-2168

05201

MADERA

MADERA COUNTY

DEPT OF PUB WELFARE

PO BOX 569

MADERA CA 93639-0569

05300

MADERA COUNTY

BEHAVIORAL HEALTH SVCS

PO BOX 1288

MADERA CA 93639

05301

MARIN

DIV OF PLANNING & ADM

HEALTH & HUMAN SRVCS

20 N SAN PEDRO RD 2027

SAN RAFAEL CA 94903-4158

05310

COUNTY OF MARIN DHHS

COMMUNITY MHS

P O BOX 2728

SAN RAFAEL CA 94912-2728

05311

MARIPOSA

MARIPOSA CO DEPT OF

HUMAN SERV — D SMITH

P O BOX 99

MARIPOSA CA 95338

05320

MENDOCINO

MENDOCINO COUNTY

SOCIAL SERVICES

P O BOX 1060

UKIAH CA 95482-1060

05330

MENDOCINO COUNTY

MENTAL HEALTH

564 S DORA ST

UKIAH CA 95482-5425

05331

MERCED

MERCED COUNTY

HUMAN SERVICES AGENCY

P O BOX 112

MERCED CA 95341-0112

05340

MODOC

MODOC COUNTY

SOCIAL SERVICES

120 MAIN ST

ALTURAS CA 96101-4045

05350

MONO

MONO COUNTY

SOCIAL SERVICES

P O BOX 576

BRIDGEPORT CA 93517-0576

05360

MONO CO

MENTAL HEALTH - IAR

PO BOX 1176

MAMMOTH LAKES CA 93546-1176

05361

MONTEREY

MONTEREY CTY DSS-IAR

1000 S MAIN ST

SUITE 208

SALINAS CA 93901-2353

05370

MONTEREY COUNTY

MENTAL HEALTH DEPT

1270 NATIVIDAD ROAD

SALINAS CA 93906-3122

05371

NAPA

NAPA COUNTY

HUMAN SERVICES

2261 ELM STREET

NAPA CA 94559-3721

05380

NAPA COUNTY

HUMAN SERVICES

2261 ELM STREET

NAPA CA 94559-3721

05381

NEVADA

NEVADA COUNTY

PUBLIC SOCIAL SERVICES

P O BOX 1210

NEVADA CITY CA 95959-1210

05390

ORANGE

ORANGE COUNTY DSS

AUDITOR CONTROLLER

P O BOX 1998

SANTA ANA CA 92702-1998

05400

ORANGE COUNTY MH

AUDITOR CONTROLLER

P O BOX 1998

SANTA ANA CA 92702-1998

05401

PLACER

PLACER COUNTY

ACCOUNTING UNIT

11552 B AVE

AUBURN CA 95603-2604

05410

PLUMAS

PLUMAS COUNTY

SOCIAL SERVICES

P O BOX 360

QUINCY CA 95971-0360

05420

RIVERSIDE

RIVERSIDE CO DPSS

RECOVERY UNIT

PO BOX 7789

RIVERSIDE CA 92513-7789

05430

RIVERSIDE COUNTY

MENTAL HEALTH

P O BOX 7549

RIVERSIDE CA 92513-7549

05431

SACRAMENTO

SACRAMENTO COUNTY

DIV REVENUE RECOVERY

10669 COLOMA RD

RANCHO CORDOVA CA 95670-4001

05440

SAN BENITO

SAN BENITO COUNTY

HUMAN SERVICES AGENCY

380 SAN BENITO ST

HOLLISTER CA 95023-3948

05450

SAN BERNARDINO

SB COUNTY-SSG AUDITING

FIRST FLOOR

825 E HOSPITALITY

SAN BERNARDINO CA 92415-0914

05460

SAN BERNARDINO

MENTAL HEALTH

700 E GILBERT BLVD 3

SAN BERNARDINO CA 92404-5413

05461

SAN DIEGO

SAN DIEGO COUNTY

OFC REVENUE RECOVERY

PO BOX 121909

SAN DIEGO CA 92112-0018

05470

TREASURER SAN DIEGO

ATTN: CHIEF MHC MGT

PO BOX 85524

SAN DIEGO CA 92186-5524

05471

SAN FRANCISCO

SAN FRANCISCO COUNTY

DEPT OF HUMAN SERVICES

PO BOX 884866

SAN FRANCISCO CA 94188-4866

05480

SAN FRANCISCO COUNTY

MHS FISCAL OFFICE

1380 HOWARD ST

SAN FRANCISCO CA 94103-2614

05481

SAN JOAQUIN

SAN JOAQUIN COUNTY

HUMAN SERVICES

PO BOX 201056

STOCKTON CA 95201-3006

05490

SAN JOAQUIN COUNTY

MENTAL HEALTH SERVICES

1212 N CALIFORNIA ST

STOCKTON CA 95202-1552

05491

SAN LUIS OBISPO

SAN LUIS OBISPO DPSS

ACCT RECEIVABLE CLERK

PO BOX 8119

SAN LUIS OBISPO CA 93403-8119

05500

SAN LUIS OBISPO COE

MNTL HLTH SVSCS - IAR

2180 JOHNSON AVE

SAN LUIS OBISPO CA 93408-7001

05501

SAN MATEO

SAN MATEO CTY SOC SVS

400 HARBOR BLVD BLDG C

BELMONT CA 94002-4047

05510

COUNTY OF SAN MATEO

DIV OF LONG TERM CARE

225 W 37TH AVE

SAN MATEO CA 94403-4324

05511

SANTA BARBARA

SANTA BARBARA COUNTY

AUDITOR CONTROLLER

P O BOX 39

SANTA BARBARA CA 93102-0039

05520

SANTA CLARA

SANTA CLARA COUNTY SSA

RECOVERY & LEGAL DIV

333 W JULIAN STREET

SAN JOSE CA 95110-1305

05530

SANTA CLARA CO MH

REP PAYEE UNIT

P O BOX 167

SAN JOSE CA 95103-0167

05531

SANTA CRUZ

SANTA CRUZ COUNTY

HUMAN RESOURCES AGCY

P O BOX 1320

SANTA CRUZ CA 95061-1320

05540

SANTA CRUZ

MENTAL HEALTH SERVICES

P O BOX 962

SANTA CRUZ CA 95061

05541

SHASTA

SHASTA COUNTY DPSS

COLLECTION UNIT

P O BOX 496005

REDDING CA 96049-6005

05550

SHASTA COUNTY MH

SPECIAL INVEST UNIT

P O BOX 496005

REDDING CA 96049-6005

05551

SIERRA

SIERRA COUNTY DSS

P O BOX 1019

LOYALTON CA 96118-1019

05560

SISKIYOU

SISKIYOU COUNTY

HUMAN SERVICES

818 S MAIN ST

YREKA CA 96097-3321

05570

SISKIYOU COUNTY

BEHAVIORAL HEALTH SVCS

2060 CAMPUS DRIVE

YREKA CA 96097-3394

05571

SOLANO

SOLANO COUNTY HHS DEPT

ADM DIV/BUDGET BUREAU

P O Box 4090 MS 5-210

FAIRFIELD CA 94533-0677

05580

SOLANO COUNTY HSS

MHS--INTERIM FUNDING

P O Box 4090 MS 5-210

FAIRFIELD CA 94533-4090

05581

SONOMA

SONOMA COUNTY

SOCIAL SERVICES

P O BOX 1539

SANTA ROSA CA 95402-1539

05590

SONOMA COUNTY

MENTAL HEALTH SERVICES

3322 CHANATE ROAD

SANTA ROSA CA 95404-1708

05591

STANISLAUS

STANISLAUS COUNTY

SUBPAYEE UNIT

P O BOX 42

MODESTO CA 95353-0042

05600

STANISLAUS COUNTY

BEHAVIORAL HEALTH SVCS

800 SCENIC DRIVE

MODESTO CA 95353

05601

SUTTER

SUTTER COUNTY

WELFARE DEPT

P O BOX 1535

YUBA CITY CA 95992-1535

05610

SUTTER YUBA

MENTAL HEALTH SERVICES

P O BOX 1520

YUBA CITY CA 95992-1520

05611

TEHEMA

TEHAMA COUNTY

SOCIAL SERVICES

P O BOX 1515

RED BLUFF CA 96080-0001

05620

TEHAMA COUNTY

MENTAL HEALTH SERVICES

1860 WALNUT STREET

RED BLUFF CA 96080-3611

05621

TRINITY

TRINITY COUNTY

HEALTH AND HUMAN

P O BOX 1470

WEAVERVILLE CA 96093-1470

05630

TRINITY CO

MENTAL HEALTH IAR

P O BOX 1640

WEAVERVILLE CA 96093-1640

05631

TULARE

TULARE COUNTY

SOCIAL SERVICES

P O BOX 671

VISALIA CA 93279-0671

05640

TULARE CTY MNTL HLTH

COMMUNITY SUPPORT

3300 S FAIRWAY

VISALIA CA 93277-8109

(*Effective 12/01/09, formerly GR 05641 consolidated IAR fiscal responsibility with GR 05640)

05640*

TUOLUMNE

TUOLUMNE COUNTY

DEPT OF SOCIAL SERVICE

20075 CEDAR ROAD NORTH

SONORA CA 95370

05650

VENTURA

VENTURA COUNTY

HUMAN SERVICES AGENCY

855 PARTRIDGE AVE

VENTURA CA 93003

05660

VENTURA CO MENTAL

PLACEMENT UNIT

300 NO HILLMONT AVE

VENTURA CA 93003-1651

05661

YOLO

YOLO COUNTY

DEPT SOCIAL SERVICES

25 NORTH COTTONWOOD

WOODLAND CA 95695-6609

05670

YOLO CO MENTAL HEALTH

137 N COTTONWOOD ST

SUITE 2500

WOODLAND CA 95695-2510

05671

YUBA

YUBA COUNTY

SOCIAL SERVICES

PO BOX 2320

MARYSVILLE CA 95901-2320

05680

STATE

PARTICIPATING AGENCYS PAYEE AND ADDRESS

GR CODE

CALIFORNIA

STATE DEPT MNTL HLTH

ACCOUNTING OFFICE

1600 9TH ST 1ST FLR

SACRAMENTO CA 95814-6404

05690

C. Hawaii – Participating Agency’s Payee, Address and GR Code:

PARTICIPATING AGENCYS PAYEE AND ADDRESS

GR CODE

STATE OF HAWAII

DEPT OF HUMAN SERVICES

P O BOX 4147

HONOLULU HI 96812-4147

12000

D. Nevada - Participating Agencies’ Payees, Addresses and GR Codes

COUNTY

PARTICIPATING AGENCYS PAYEE AND ADDRESS

GR CODE

CARSON CITY

CARSON CITY

HEALTH AND HUMAN SERVICE

900 E LONG ST

CARSON CITY NV 89701

29120

CLARK

DIRECTOR

CLARK CTY SOC SRVCS

1600 PINTO LANE

LAS VEGAS NV 89106-4102

29010

DOUGLAS

DOUGLAS COUNTY SOC SER

ATTN: DIRECTOR

1133 SPRUCE ST

GARDNERVILLE NV 89410

29020

ELKO

DIRECTOR-SSI IAR

ELKO COUNTY COURTHOUSE

571 IDAHO STREET

ELKO NV 89801-3762

29030

WASHOE

WASHOE COUNTY DSS

DIRECTOR

PO BOX 11130

RENO NV 89520-0027

29150

STATE

PARTICIPATING AGENCYS PAYEE AND ADDRESS

GR CODE

NEVADA

(MENTAL HEALTH AND DEVELOPMENTAL SERVICES)

ADMINISTRATOR-MH/DSD

505 EAST KING ST

KINKEAD BLDG, ROOM 602

CARSON CITY NV 89701-3790

29121


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502003001SF
SI SF02003.001 - State Interim Assistance (IA) Agencies (TN 2 - 04/2007) - 06/01/2010
Batch run: 06/01/2010
Rev:06/01/2010