Healthcare Provider Details

I. General information

NPI: 1205809381
Provider Name (Legal Business Name): THE REDWOODS, A COMMUNITY OF SENIORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CAMINO ALTO
MILL VALLEY CA
94941
US

IV. Provider business mailing address

40 CAMINO ALTO
MILL VALLEY CA
94941-2956
US

V. Phone/Fax

Practice location:
  • Phone: 415-383-2741
  • Fax: 415-373-0115
Mailing address:
  • Phone: 415-383-2741
  • Fax: 415-383-4768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: LYNETTE CLARK
Title or Position: CFO
Credential:
Phone: 415-383-2741