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General NPI Number Information
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NPI Number | 1487382743
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Entity Type | Organization
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Legal Business Name | MUIR WOOD, LLC.
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 6851 COLD SPRINGS RD
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City | PENNGROVE
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State | CA
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Zip | 94951-9722
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Country | US
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Telephone | 415-497-7722
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Fax |
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Provider Business Mailing Address
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Address Line | 201 1ST ST STE 111
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City | PETALUMA
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State | CA
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Zip | 94952-4291
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Country | US
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Telephone | 855-684-7966
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Fax | 707-781-4276
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Authorized Official
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Title or Position | COO
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Name | BRYAN BOWEN
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Credential |
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Telephone | 415-497-7722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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