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General NPI Number Information
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NPI Number | 1699150243
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Entity Type | Organization
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Legal Business Name | REDWOOD COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 800 N STATE ST
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City | UKIAH
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State | CA
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Zip | 95482-3410
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Country | US
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Telephone | 707-468-5536
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Fax | 707-467-9034
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Provider Business Mailing Address
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Address Line | 800 NORTH STATE STREET PO BOX 422
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City | UKIAH
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State | CA
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Zip | 95482-5348
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Country | US
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Telephone | 707-467-2010
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Fax | 707-462-6994
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Authorized Official
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Title or Position | CEO
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Name | VICTORIA J KELLY
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Credential | LCSW
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Telephone | 707-472-2922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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