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General NPI Number Information
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NPI Number | 1043848831
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Entity Type | Organization
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Legal Business Name | CRESTWOOD BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 03/29/2020
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 7440 RANCHO LOS GUILICOS RD
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City | SANTA ROSA
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State | CA
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Zip | 95409-6540
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Country | US
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Telephone | 707-639-4696
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Fax | 707-539-6106
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Provider Business Mailing Address
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Address Line | 7440 RANCHO LOS GUILICOS RD
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City | SANTA ROSA
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State | CA
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Zip | 95409-6540
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Country | US
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Telephone | 707-639-4696
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR AR AND REIMB.
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Name | MICHELLE SMITH
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Credential |
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Telephone | 209-955-2364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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