| Madrone House | |
|
7351 Sems Ln Redwood Valley CA 95470 | |
| (707) 467-9192 | |
| (707) 467-9345 |
| Full Name | Madrone House |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7351 Sems Ln, Redwood Valley, California |
| Authorized Official Name and Position | Victoria Jersuha Kelly (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7074672010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madrone House Po Box 2077 Ukiah CA 95482-2077 Ph: (707) 467-2010 | Madrone House 7351 Sems Ln Redwood Valley CA 95470 Ph: (707) 467-9192 |
| NPI Number | 1538445358 |
|---|---|
| Provider Enumeration Date | 10/25/2011 |
| Last Update Date | 01/21/2020 |
| Certification Date | 01/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538445358 | NPI | - | NPPES |
| 23CI | Other | CA | MENDOCINO COUNTY PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Secondary |
Art Therapy Institute Of The Redwoods Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10151 East Rd, Redwood Valley, CA 95470 Phone: 707-485-0105 Fax: 707-485-5060 |