Healthcare Provider Details

I. General information

NPI: 1700725561
Provider Name (Legal Business Name): PEERS FOR INDEPENDENCE AND RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 SUTTON WAY
GRASS VALLEY CA
95945-5174
US

IV. Provider business mailing address

1103 SUTTON WAY
GRASS VALLEY CA
95945-5174
US

V. Phone/Fax

Practice location:
  • Phone: 530-274-1431
  • Fax: 530-274-1431
Mailing address:
  • Phone: 530-274-1431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELLE AUGUST ROSE
Title or Position: GRANT WRITER
Credential:
Phone: 530-277-1491