Healthcare Provider Details

I. General information

NPI: 1891911830
Provider Name (Legal Business Name): ENCOMPASS COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 MAPLE AVE
WATSONVILLE CA
95076-4709
US

IV. Provider business mailing address

380 ENCINAL ST SUITE 200
SANTA CRUZ CA
95060-2178
US

V. Phone/Fax

Practice location:
  • Phone: 831-226-3728
  • Fax: 831-761-3772
Mailing address:
  • Phone: 831-469-1700
  • Fax: 831-425-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number440008LN
License Number StateCA

VIII. Authorized Official

Name: MONICA MARTINEZ
Title or Position: CEO
Credential:
Phone: 831-469-1700