MUIR WOOD LLC (NPI# 1598376816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598376816 |
| Entity Type | Organization |
| Organization Name | MUIR WOOD LLC |
| Other Organization Name | MUIR WOOD ADOLESCENT FAMILY SERVICES |
| Practice Address |
6868 Cold Springs Rd Penngrove CA 94951-9722 |
| Mailing Address |
1733 Skillman Ln Petaluma CA 94952-1250 |
| Practice Telephone | 8664780721 |
| Mailing Telephone | 4154977722 |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-26 |
| Authorized Official Name | ROBERT BRYAN BOWEN (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 4154977722 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| COMMERCIAL | 422794167 | 01 | |
| CA | COMMERCIAL | 422794167 | 01 |
| Other Name | Type Code |
|---|---|
| Muir Wood Adolescent Family Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780282988 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 2891 I Street Ext, Petaluma, CA 94952-9521 | 2020-10-12 |
| 1417461955 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 343 Haverfield Ln, Petaluma, CA 94952-1872 | 2017-11-20 |
| 1710376686 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 55 Shaver St, Suite 200, San Rafael, CA 94901-2787 | 2015-01-15 |
| 1306273636 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 1733 Skillman Ln, Petaluma, CA 94952-1250 | 2013-10-01 |
| Street Address |
6868 COLD SPRINGS RD |
| City | PENNGROVE |
| State | CA |
| Zip Code | 94951-9722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639783848 | Christina N Wallace | Massage Therapist | 308 Oak Street, Penngrove, CA 94951 | 2020-09-04 |
| 1922126689 | Regina Ann Wilson-seppa | Specialist | 730 Goodwin Ave, Penngrove, CA 94951-8623 | 2007-03-27 |
| 1578912481 | Jennifer Lisa Madrid | Licensed Psychiatric Technician | 574 Formschlag Ln, Penngrove, CA 94951-8715 | 2016-06-10 |
| 1740673748 | Alexander Edward Perrotti | Marriage & Family Therapist | 3450 Lichau Rd, Penngrove, CA 94951-8720 | 2015-03-15 |
| 1053382911 | Robert Rowen Herzog | Physical Therapist | 8690 Petaluma Hill Rd, Penngrove, CA 94951-8734 | 2006-01-30 |
| 1467416743 | Donald Minor | Specialist | 4960 Rebecca Dr, Penngrove, CA 94951-9519 | 2006-04-13 |
| 1689080194 | Edward Rosen | Physical Therapist | 6575 Eagle Ridge Rd, Penngrove, CA 94951-9575 | 2014-07-03 |
| 1083112221 | Kimberly Ann Brasil | Dental Hygienist | 9663 Old Redwood Hwy, Penngrove, CA 94951-9610 | 2018-01-23 |
| 1356458541 | Alexandra Advocate | Marriage & Family Therapist | 10864 Minnesota Ave, Penngrove, CA 94951-9617 | 2006-08-24 |
| 1043628829 | Stephen Smith | Counselor | 520 Orchard Ln, Penngrove, CA 94951-9659 | 2014-07-24 |
| Find all providers in zip 94951 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275620 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 80 W Nicasio, San Geronimo, CA 94963 | 2020-11-05 |
| 1013518042 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1208 Via Aracena, Camarillo, CA 93010-7440 | 2020-11-05 |
| 1609477645 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1850 Calle Alberca, Camarillo, CA 93010-1811 | 2020-11-05 |
| 1467053736 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 615 Bugeia Ln, Novato, CA 94945-1517 | 2020-11-04 |
| 1376144642 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 100 Avocado Pl, Camarillo, CA 93010-8467 | 2020-11-04 |
| 1285235556 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 7210 Johnston Rd, Pleasanton, CA 94588-9466 | 2020-11-04 |
| 1780282988 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 2891 I Street Ext, Petaluma, CA 94952-9521 | 2020-10-12 |
| 1720692577 | Muir Wood, LLC. | Substance Abuse Rehabilitation Facility | 1743 Skillman Lane, Petaluma, CA 94952-9495 | 2020-08-31 |
| 1770194060 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 195 S Peralta Hills Dr, Anaheim, CA 92807-3424 | 2020-08-11 |
| 1477161149 | Asian American Drug Abuse Program, Inc | Substance Abuse Rehabilitation Facility | 4625 Crenshaw Blvd, Los Angeles, CA 90043-1209 | 2020-07-20 |
| Find all providers with the same taxonomy | ||||
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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.