Healthcare Provider Details

I. General information

NPI: 1366246332
Provider Name (Legal Business Name): CDT SERVICE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 ROLOFF WAY
ORANGEVALE CA
95662-4532
US

IV. Provider business mailing address

1741 E ROSEVILLE PKWY STE 100
ROSEVILLE CA
95661-6450
US

V. Phone/Fax

Practice location:
  • Phone: 916-784-1149
  • Fax: 866-336-7276
Mailing address:
  • Phone: 916-784-1149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ROSS STUART MORTON
Title or Position: CEO
Credential: JD
Phone: 916-784-1149