MUIR WOOD, LLC. (NPI# 1962016733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962016733 |
| Entity Type | Organization |
| Organization Name | MUIR WOOD, LLC. |
| Practice Address |
320 Washington St Petaluma CA 94952-2955 |
| Mailing Address |
1733 Skillman Ln Petaluma CA 94952-1250 |
| Practice Telephone | 4154977722 |
| Mailing Telephone | 4154977722 |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | BRYAN BOWEN (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 4154977722 |
| Is Organization Subpart | Y |
| Parent Organization Name | MUIR WOOD, LLC. |
| 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 |
|---|---|---|---|
| CA | COMMERCIAL | 422794167 | 01 |
| Other Name | Type Code |
|---|---|
| Muir Wood Adolescent and Family Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692577 | Muir Wood, LLC. | Substance Abuse Rehabilitation Facility | 1743 Skillman Lane, Petaluma, CA 94952-9495 | 2020-08-31 |
| Street Address |
320 WASHINGTON ST |
| City | PETALUMA |
| State | CA |
| Zip Code | 94952-2955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
| 1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
| 1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
| 1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
| 1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
| 1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
| 1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
| 1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
| 1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
| 1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
| Find all providers in zip 94952 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1417461955 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 343 Haverfield Ln, Petaluma, CA 94952-1872 | 2017-11-20 |
| 1306273636 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 1733 Skillman Ln, Petaluma, CA 94952-1250 | 2013-10-01 |
| 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 |
| 1598376816 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 6868 Cold Springs Rd, Penngrove, CA 94951-9722 | 2020-08-11 |
| 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 |
| 1427671882 | Dhhs Ihs Cao Sacred Oaks Healing Center | Substance Abuse Rehabilitation Facility | 33100 County Road 31, Davis, CA 95616 | 2020-05-20 |
| 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.