Individual provider · Type 1 NPI

Shannon Wooderson

Emotionally Disturbed Childrens' Residential Treatment Facility · Grass Valley, CA

NPI number 1295963809 Active

Practice location

714 W Main St
Grass Valley, CA 95945-6410

Call (530) 477-9800 Map

Fax (530) 477-9803

Specialties and licenses

TaxonomyCodeLicense
Emotionally Disturbed Childrens' Residential Treatment Facility Primary 322D00000XNone listed

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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About NPI 1295963809

Shannon Wooderson's National Provider Identifier is 1295963809, issued on Jun 23, 2009. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Grass Valley, CA. The record was last updated on Jun 23, 2009.