COUTY OF MENDOCINO


Address: 1011 Low Gap Road, Ukiah, CA 95482
Phone: 7074636878

COUTY OF MENDOCINO (NPI# 1770705139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770705139
Entity Type Organization
Organization Name COUTY OF MENDOCINO
Other Organization Name ORR CREEK DAY TREATMENT PROGRAM
Practice Address 1011 Low Gap Road
Ukiah
CA 95482
Mailing Address 1120 S Dora St
Ukiah
CA 95482-3919
Practice Telephone 7074636878
Mailing Telephone 7074722300
Enumeration Date 2007-05-03
Last Update Date 2014-02-03
Authorized Official Name TOM PINIZOTTO (DIRECTOR)
Authorized Official Telephone 7074722300
Authorized Official Credential MSW
Is Organization Subpart Y
Parent Organization Name COUTY OF MENDOCINO

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 251S00000X Community/Behavioral Health Agencies
N 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities
N 302F00000X Exclusive Provider Organization Managed Care Organizations
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA 2390 05
CA 00023 05

Other Provider/Organization Names

Other Name Type Code
Orr Creek Day Treatment Program Other Name - Individual/Organization

Office Location

Street Address 1011 LOW GAP ROAD
City UKIAH
State CA
Zip Code 95482

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508296989 Tapestry Family Services Community/Behavioral Health 1011 Low Gap Road, Ukiah, CA 95482 2013-11-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932726726 Gloria Gonzalez Campise Midwife 205 W. Clay Street, Ukiah, CA 95482 2020-06-29
1083255095 Mendocino Care Network Internal Medicine 1080 N State St, Ukiah, CA 95482 2019-10-01
1801383153 Costco Wholesale Corporation Pharmacy 1275 Airport Park Blvd., Ukiah, CA 95482 2018-04-21
1922528256 Ian David Winter Case Manager/Care Coordinator 1120 S. Dora St, Ukiah, CA 95482 2017-06-27
1568917938 Rebecca Ann Dragomani Nurse Practitioner 260 Hospital Dr Ste 101, Ukiah, CA 95482 2016-08-16
1811362536 Manzanita Services, Inc. Community/Behavioral Health 410 W. Jones St., Ukiah, CA 95482 2015-12-07
1689061061 Pamela Mathias Counselor 367 East Gobbi Street, Suite E, Ukiah, CA 95482 2015-04-23
1275927030 Jack David Segel Counselor 564 Dora St., Ste.d, Ukiah, CA 95482 2015-03-19
1689070211 Mendocino County Youth Project Clinic/Center 347 Plum St, #b, Ukiah, CA 95482 2014-11-10
1346649951 Ae Ran Ku Dentist 1096 South Dora Street, Ukiah, CA 95482 2014-08-19
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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1922581537 Solid Ground Counseling and Therapy Services Inc Clinic/Center 1120 W Church St, Ukiah, CA 95482-4603 2018-09-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1073112157 10-20 Club Inc. Clinic/Center 8221 3rd St Ste 403, Downey, CA 90241-3733 2020-10-20
1447857040 Mary Cox, Lmft Clinic/Center 13800 Heacock St Ste 230a, Moreno Valley, CA 92553-8824 2020-10-06
1821607771 Tonya Octave, Lcsw, Prof Corp Clinic/Center 237 S Lakeview Ave Ste A, Placentia, CA 92870-6756 2020-07-27
1972121762 Environmental Alternatives Susanville Clinic/Center 2003 Main St, Susanville, CA 96130-4501 2020-07-08
1083231781 Treehouse Child Therapy Professional Corporation Clinic/Center 514 N California Ave Ste 13, Beaumont, CA 92223-2120 2020-06-29
1083230262 Socal Adolescent Wellness, Inc. Clinic/Center 23072 Lake Center Dr Ste 214, Lake Forest, CA 92630-2899 2020-06-23
1447876123 P.h.i.l.o.s.adolescent Treatment Centers, Inc. Clinic/Center 454 E Cerritos St, Rialto, CA 92376-3658 2020-06-18
1669098505 Rowi Valencia, Inc. Clinic/Center 27413 Tourney Rd Ste 150, Valencia, CA 91355-5604 2020-06-16
1386267870 Bni Treatment Centers Clinic/Center 2563 Stokes Canyon Rd, Calabasas, CA 91302-2991 2020-05-19
1538781042 P.h.i.l.o.s.adolescent Treatment Centers, Inc. Clinic/Center 3872 Carthage St, Riverside, CA 92501-2102 2020-05-07
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Competitor

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City UKIAH
Zip Code 95482

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Dataset Information

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.

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