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NPI Code Detail

MEDICARE: REDWOOD COMMUNITY SERVICES, INC

MEDICARE: REDWOOD COMMUNITY SERVICES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1093479206
Entity Type Code : Organization
Provider Name (Legal Business Name) : REDWOOD COMMUNITY SERVICES, INC
Provider Business Mailing Address
First Line : 631 S ORCHARD AVE
Second Line :
City : UKIAH
State : CA
Zip : 95482-5011
Country : US
Telephone Number : 707-467-2010
Fax Number :
Provider Business Practice Location Address
First Line : 2143 F ST
Second Line :
City : EUREKA
State : CA
Zip : 95501-3738
Country : US
Telephone Number : 707-467-2010
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : VICTORIA J KELLY
Credential : LCSW
Telephone Number : 707-467-2010
Provider Enumeration Date : 10/25/2021
Last Update Date : 01/18/2024

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Directions to “REDWOOD COMMUNITY SERVICES, INC ” Practice Location

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