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NPI Code Detail

MEDICARE: SCOTTS VALLEY TREATMENT CENTER INC

MEDICARE: SCOTTS VALLEY TREATMENT CENTER 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
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1255078747
Entity Type Code : Organization
Provider Name (Legal Business Name) : SCOTTS VALLEY TREATMENT CENTER INC
Provider Business Mailing Address
First Line : PO BOX 4869
Second Line :
City : SANTA ROSA
State : CA
Zip : 95402-4869
Country : US
Telephone Number : 707-284-1235
Fax Number : 707-284-1236
Provider Business Practice Location Address
First Line : 3250 GUERNEVILLE RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4030
Country : US
Telephone Number : 707-579-4066
Fax Number : 707-284-1236
Authorized Official
Title or Position : CEO
Name : THOMAS J JORDAN
Credential :
Telephone Number : 707-349-8545
Provider Enumeration Date : 05/16/2022
Last Update Date : 12/04/2025

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Directions to “SCOTTS VALLEY TREATMENT CENTER INC ” Practice Location

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