| Redwood Community Services, Inc | |
|
154 S Main St Lakeport CA 95453-5017 | |
| (707) 263-0372 | |
| Not Available |
| Full Name | Redwood Community Services, Inc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 154 S Main St, Lakeport, California |
| Authorized Official Name and Position | Victoria Jerusha Kelly (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7074672010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Redwood Community Services, Inc Po Box 2077 Ukiah CA 95482-2077 Ph: (707) 467-2010 | Redwood Community Services, Inc 154 S Main St Lakeport CA 95453-5017 Ph: (707) 263-0372 |
| NPI Number | 1366709461 |
|---|---|
| Provider Enumeration Date | 04/13/2012 |
| Last Update Date | 12/10/2020 |
| Certification Date | 12/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366709461 | NPI | - | NPPES |
| 171721 | Other | CA | CALOMS # |
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