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General NPI Number Information
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NPI Number | 1194971473
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Entity Type | Organization
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Legal Business Name | JANUS OF SANTA CRUZ
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 516 CHESTNUT ST.
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City | SANTA CRUZ
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State | CA
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Zip | 95060-3669
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Country | US
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Telephone | 831-423-9015
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Fax | 831-423-9098
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Provider Business Mailing Address
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Address Line | 200 7TH AVENUE SUITE 150
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City | SANTA CRUZ
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State | CA
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Zip | 95062-4668
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Country | US
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Telephone | 831-462-1060
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Fax | 831-462-4970
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | AMBER WILLIAMS
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Credential |
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Telephone | 831-278-7906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 440003DN
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License Number State | CA
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