Organization · Type 2 NPI

Buckelew Programs

Substance Abuse Rehabilitation Facility · Santa Rosa, CA

NPI number 1184304776 Active

Practice location

1430 Neotomas Ave
Santa Rosa, CA 95405-7575

Call (707) 565-7450 Map

Mailing address

201 Alameda Del Prado Ste 103
Novato, CA 94949-6698

Specialties and licenses

Taxonomy	Code	License
Substance Abuse Rehabilitation Facility Primary	324500000X	None listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

65 other providers at this address

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NPI record

NPI: 1184304776
Entity type: Organization (Type 2)
Issued: Jul 19, 2023
Last updated: Mar 4, 2024
Status: Active
Subpart: Yes of Buckelew Programs

Other names

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Athena House · doing business as
Buckelew Orenda Center · doing business as

Authorized official

John Christopher Kughn, LMFT
CEO
(415) 457-6966

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1184304776

Buckelew Programs's National Provider Identifier is 1184304776, issued on Jul 19, 2023. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Santa Rosa, CA. The record was last updated on Mar 4, 2024.