Healthcare Provider Details

I. General information

NPI: 1790498327
Provider Name (Legal Business Name): NORTH COAST OPPORTUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 N STATE ST
UKIAH CA
95482-4421
US

IV. Provider business mailing address

413 N STATE ST
UKIAH CA
95482-4421
US

V. Phone/Fax

Practice location:
  • Phone: 707-467-3200
  • Fax: 707-462-0191
Mailing address:
  • Phone: 707-467-3200
  • Fax: 707-462-0191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: PATTY BRUDER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 707-467-3200