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General NPI Number Information
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NPI Number | 1104331933
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Entity Type | Organization
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Legal Business Name | CALIFORNIA HUMAN DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 12/01/2017
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Last Update Date | 12/01/2017
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Provider Practice Location Address
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Address Line | 2400A COUNTY CENTER DR
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City | SANTA ROSA
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State | CA
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Zip | 95403-3004
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Country | US
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Telephone | 707-523-2242
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Fax | 707-546-1937
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Provider Business Mailing Address
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Address Line | 3315 AIRWAY DR
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City | SANTA ROSA
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State | CA
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Zip | 95403-2005
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Country | US
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Telephone | 707-523-2242
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Fax | 707-546-1937
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DANA J ALVAREZ
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Credential |
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Telephone | 707-523-2242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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