Healthcare Provider Details

I. General information

NPI: 1073435814
Provider Name (Legal Business Name): WEST COUNTY COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 CHALLENGER WAY # 104
SANTA ROSA CA
95407-5418
US

IV. Provider business mailing address

PO BOX 325
GUERNEVILLE CA
95446-0325
US

V. Phone/Fax

Practice location:
  • Phone: 707-565-7800
  • Fax: 707-823-1642
Mailing address:
  • Phone: 707-823-1640
  • Fax: 707-823-1642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY DAVILA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 707-823-1640