Healthcare Provider Details

I. General information

NPI: 1831983683
Provider Name (Legal Business Name): UNITY FULL CIRCLE RECOVERY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1849 CLAY ST
FAIRFIELD CA
94533-3810
US

IV. Provider business mailing address

1849 CLAY ST
FAIRFIELD CA
94533-3810
US

V. Phone/Fax

Practice location:
  • Phone: 707-770-7095
  • Fax:
Mailing address:
  • Phone: 707-770-7095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ROSHAWN ADAMS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 707-563-7272