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General NPI Number Information
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NPI Number | 1558161646
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Entity Type | Organization
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Legal Business Name | MENDING INDIGENOUS SPIRITS
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 106 COYOTE VALLEY BLVD
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City | REDWOOD VALLEY
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State | CA
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Zip | 95470-9486
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Country | US
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Telephone | 707-657-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 GUMVIEW RD
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City | WINDSOR
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State | CA
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Zip | 95492-9423
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Country | US
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Telephone | 707-657-8550
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Fax |
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Authorized Official
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Title or Position | VCCHAIR/COFOUNDER
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Name | SARAH TANG
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Credential |
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Telephone | 707-657-8550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 374T00000X
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Taxonomy Name | Religious Nonmedical Nursing Personnel
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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