Organization · Type 2 NPI

Redwood Community Services, Inc

Substance Abuse Rehabilitation Facility · Upper Lake, CA

NPI number 1265897029 Active

Practice location

675 1st St
Upper Lake, CA 95485

Call (707) 275-8776 Map

Mailing address

PO Box 2077, 631 S. Orchard Street
Ukiah, CA 95482-2077

Specialties and licenses

Taxonomy	Code	License
Case Management Agency	251B00000X	None listed
Community/Behavioral Health Agency	251S00000X	None listed
Early Intervention Provider Agency	252Y00000X	None listed
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.

9 other providers at this address

NPI record

NPI: 1265897029
Entity type: Organization (Type 2)
Issued: Dec 22, 2015
Last updated: Jan 21, 2020
Status: Active
Subpart: Yes of Redwood Community Services, Inc.

Other names

<unavail>
H.o.m.e. Tule House · other name
H.o.m.e. Tule House · other name

Authorized official

Mrs. Victoria Jersuha Kelly, LCSW
Chief Executive Officer
(707) 467-2010

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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 1265897029

Redwood Community Services, Inc's National Provider Identifier is 1265897029, issued on Dec 22, 2015. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Upper Lake, CA. The record was last updated on Jan 21, 2020.