WILLOW GLEN CARE CENTER NPI 1760819767

NPI Information

NPI: 1760819767
Provider Name: WILLOW GLEN CARE CENTER

Other Name: REDWOOD CREEK

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
414 S MAIN ST
WILLITS, CA
ZIP 95490
Phone: (707) 459-6134
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WILLOW GLEN CARE CENTER is a community based residential treatment facility mental illness in Willits, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. WILLOW GLEN CARE CENTER NPI is 1760819767. The provider is registered as an organization entity type.
The provider Other Name Is Redwood Creek.

The provider's business location address is:

414 S MAIN ST
WILLITS, CA
ZIP 95490-908
Phone: (707) 459-6134
Fax: (707) 459-9252

The provider's authorized official is Jeff Payne .
The authorized official title is Chief Operations Officer and has the following contact phone number (530) 751-9904.

The enumeration date for this NPI number is 10/4/2013 and was last updated on 7/27/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		236803329	CALIFORNIA	Yes

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

NPI Synchronization or Removal

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