Individual provider · Type 1 NPI
Stacy Roudebush
Substance Abuse Rehabilitation Facility · Rohnert Park, CA
NPI number
1730559303
Active
Practice location
308 Firethorn Dr
Rohnert Park, CA 94928-1321
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Abuse Rehabilitation Facility Primary | 324500000X | B6655711 (CA) |
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.
Another provider at this address
About NPI 1730559303
Stacy Roudebush's National Provider Identifier is 1730559303, issued on Sep 25, 2015. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Rohnert Park, CA. The record was last updated on Sep 25, 2015.