REDWOOD COMMUNITY SERVICES, INC (NPI# 1265897029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265897029 |
| Entity Type | Organization |
| Organization Name | REDWOOD COMMUNITY SERVICES, INC |
| Other Organization Name | H.O.M.E. TULE HOUSE |
| Practice Address |
675 1st St Upper Lake CA 95485 |
| Mailing Address |
Po Box 2077 631 S. Orchard Street Ukiah CA 95482-2077 |
| Practice Telephone | 7072758776 |
| Mailing Telephone | 7074672010 |
| Mailing Fax Number | 7074634931 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2020-01-21 |
| Authorized Official Name | MRS. VICTORIA JERSUHA KELLY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7074672010 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | Y |
| Parent Organization Name | REDWOOD COMMUNITY SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| H.O.M.E. Tule House | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558702795 | Redwood Community Services, Inc | Community/Behavioral Health | 800 N. State Street, (rcs - Mffa / Tfc), Ukiah, CA 95482 | 2013-07-16 |
| 1174778674 | Redwood Community Services, Inc | Case Management | 150 Gibson St, Ukiah, CA 95482-3941 | 2008-11-25 |
| 1407351653 | Redwood Community Services, Inc | Case Management | 110 E Mendocino Ave, Willits, CA 95490-3508 | 2018-03-29 |
| 1518418482 | Redwood Community Services, Inc | Counselor | 9981b Spring Valley Rd, Potter Valley, CA 95469-9713 | 2016-10-17 |
| 1528496619 | Redwood Community Services, Inc | Private Vehicle | 544 S Main St, Fort Bragg, CA 95437-5107 | 2013-10-29 |
| 1366709461 | Redwood Community Services, Inc | Counselor | 154 S Main St, Lakeport, CA 95453-5017 | 2012-04-13 |
| 1831237015 | Redwood Community Services, Inc | Counselor | 631 S Orchard Ave, Ukiah, CA 95482-5011 | 2007-02-01 |
| Street Address |
675 1ST ST |
| City | UPPER LAKE |
| State | CA |
| Zip Code | 95485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639370505 | Kathleen May Brooner | Counselor | 675 1st St, Upper Lake, CA 95485-9586 | 2007-05-30 |
| 1932672680 | Andrea Coronado | Counselor | 675 1st St, Upper Lake, CA 95485-9586 | 2019-01-05 |
| 1720557945 | Lisa Davies | Counselor | 675 1st St, Upper Lake, CA 95485-9586 | 2018-11-16 |
| 1861961013 | Christina Briseno | Counselor | 675 1st St, Upper Lake, CA 95485-9586 | 2018-11-16 |
| 1629547930 | Sarah Lemmon | Counselor | 675 1st St, Upper Lake, CA 95485-9586 | 2018-11-15 |
| 1154874576 | Michaela Marrapese | Counselor | 675 1st St, Upper Lake, CA 95485-9586 | 2016-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679874861 | Florence C. Irvine | Psychiatry & Neurology | 15525 Elk Mountain Road, Upper Lake, CA 95485 | 2010-11-04 |
| 1629301775 | Sutter West Bay Hospitals | Clinic/Center | 750 Old Lucerne Road, Upper Lake, CA 95485-0000 | 2009-09-08 |
| 1316928807 | Debra K. Fenton | Nurse Practitioner | 750 Old Lucerne Rd, Upper Lake, CA 95485-8755 | 2005-11-10 |
| 1043749369 | Isabel Gregorio-flores | Behavior Technician | 590 Melody Ln, Upper Lake, CA 95485-8782 | 2017-06-08 |
| 1730360975 | Rebecca A Rogers | Counselor | 565 Clover Dr, Upper Lake, CA 95485-9233 | 2007-11-15 |
| 1538207360 | Rayna S Freedman | Marriage & Family Therapist | 9860 Middle Creek Rd, Upper Lake, CA 95485-9265 | 2007-02-02 |
| 1578800710 | Elizabeth M Cumings | Counselor | 9860 Middle Creek Rd, Upper Lake, CA 95485-9265 | 2013-01-08 |
| 1407100290 | Ann Martin | Counselor | 9860 Middle Creek Rd, Upper Lake, CA 95485-9265 | 2012-11-01 |
| 1578719134 | Kathryn C Reisig | Marriage & Family Therapist | 9860 Middle Creek Rd, Upper Lake, CA 95485-9265 | 2008-08-14 |
| 1124283890 | April D Byerly | Counselor | 9860 Middle Creek Rd, Upper Lake, CA 95485-9265 | 2008-07-22 |
| Find all providers in zip 95485 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
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| 1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
| 1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | UPPER LAKE |
| Zip Code | 95485 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.