| Valley Of The Moon Children's Home | |
|
112 Childrens Cir Santa Rosa CA 95409-6558 | |
| (707) 565-4850 | |
| Not Available |
| Full Name | Valley Of The Moon Children's Home |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 112 Childrens Cir, Santa Rosa, California |
| Authorized Official Name and Position | Ruby Zhang (DEPARTMENT ANALYST) |
| Authorized Official Contact | 7075657846 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Of The Moon Children's Home Po Box 1539 Santa Rosa CA 95402-1539 Ph: () - | Valley Of The Moon Children's Home 112 Childrens Cir Santa Rosa CA 95409-6558 Ph: (707) 565-4850 |
| NPI Number | 1306050828 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 05/23/2023 |
| Certification Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306050828 | NPI | - | NPPES |
| 49B9 | Other | CA | PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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