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CRESTWOOD BEHAVIORAL HEALTH INC. NPI 1508935834


NPI Information

NPI: 1508935834
Provider Name: CRESTWOOD BEHAVIORAL HEALTH, INC.

Doing Business As: CRESTWOOD RECOVERY & REHAB. CENTER

Classification: Intermediate Care Facility, Mental Illness - 310500000X
Entity Type: Organization

CLIA Number: 05D0861563

Address:
115 ODDSTAD DR
VALLEJO, CA
ZIP 94589
Phone: (707) 552-0215
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CRESTWOOD BEHAVIORAL HEALTH, INC. is an intermediate care facility mental illness in Vallejo, CA. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. CRESTWOOD BEHAVIORAL HEALTH, INC. NPI is 1508935834. The provider is registered as an organization entity type.
The provider Is Doing Business As Crestwood Recovery & Rehab. Center.

The provider's business location address is:

115 ODDSTAD DR
VALLEJO, CA
ZIP 94589-520
Phone: (707) 552-0215
Fax: (707) 553-1424

The provider's authorized official is Lori Blackburn .
The authorized official title is Vice President and has the following contact phone number (209) 955-2322.

The CLIA number assigned to this NPI record is 05D0861563 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 5/19/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310500000XIntermediate Care Facility, Mental Illness02060027CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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