Healthcare Provider Details

I. General information

NPI: 1770844417
Provider Name (Legal Business Name): ALTERNATIVE FAMILY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 06/16/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131B STONY CIR SUITE 1200
SANTA ROSA CA
95401-9507
US

IV. Provider business mailing address

131B STONY CIRCLE SUITE 1200
SANTA ROSA CA
95401-9507
US

V. Phone/Fax

Practice location:
  • Phone: 707-576-7700
  • Fax: 707-576-9700
Mailing address:
  • Phone: 707-576-7700
  • Fax:

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: MARSHA LEWIS-AKYEEM, M.S.
Title or Position: EXECUTIVE DIRECTOR
Credential: M.S.
Phone: 916-202-7480