FORMATIVE CARE INC. NPI 1164897930

NPI Information

  • NPI: 1164897930
  • Provider Name: FORMATIVE CARE, INC.
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: THE BELDEN HOUSE
  • Address: 606 HUMBOLDT ST
    SANTA ROSA, CA
    ZIP 95404
  • Phone: (707) 579-2735

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NPI Details

FORMATIVE CARE, INC. is an assisted living facility in Santa Rosa, CA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. FORMATIVE CARE, INC. NPI is 1164897930. The provider is registered as an organization entity type.
The provider Is Doing Business As The Belden House.

The provider's business location address is:

606 HUMBOLDT ST
SANTA ROSA, CA
ZIP 95404-219
Phone: (707) 579-2735
Fax: (707) 579-4145

The provider's authorized official is Jordan Harding .
The authorized official title is Director and has the following contact phone number (707) 579-2735.

The enumeration date for this NPI number is 12/4/2015 and was last updated on 12/4/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility496801719CALIFORNIAYes

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: 11/21/2025

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