REDWOOD COMMUNITY SERVICES, INC. (NPI# 1982017844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982017844 |
| Entity Type | Organization |
| Organization Name | REDWOOD COMMUNITY SERVICES, INC. |
| Other Organization Name | ARBOR OUTPATIENT DRUG FREE CLINIC / RESOURCE CENTER |
| Practice Address |
810 N State St Ukiah CA 95482-3410 |
| Mailing Address |
Po Box 2077 Ukiah CA 95482-2077 |
| Practice Telephone | 7074627267 |
| Practice Fax Number | 7074622789 |
| Mailing Telephone | 7074672010 |
| Enumeration Date | 2014-06-09 |
| 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 | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| N | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICAL SPMH PROVIDER CERTIFICATION NUMBER | 23CX | 01 |
| Other Name | Type Code |
|---|---|
| Arbor Outpatient Drug Free Clinic / Resource Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184118929 | Redwood Community Services, Inc. | Case Management | 9981a Spring Valley Rd, Potter Valley, CA 95469-9713 | 2018-06-15 |
| 1164951851 | Redwood Community Services, Inc. | Foster Care Agency | 2426 6th St, Eureka, CA 95501 | 2017-06-07 |
| 1326305152 | Redwood Community Services, Inc. | Case Management | 310 3rd St, Eureka, CA 95501-0492 | 2012-04-18 |
| 1538445358 | Redwood Community Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 7351 Sems Ln, Redwood Valley, CA 95470 | 2011-10-25 |
| 1285772251 | Redwood Community Services, Inc. | Marriage & Family Therapist | 6150 Orr Springs Rd, Ukiah, CA 95482-9032 | 2007-02-02 |
| 1174661284 | Redwood Community Services, Inc. | Marriage & Family Therapist | 99 S Humboldt St, Willits, CA 95490-3509 | 2007-02-01 |
| 1487172375 | Redwood Community Services, Inc. | Case Management | 320 1st St, Lakeport, CA 95453-4706 | 2017-08-31 |
| 1578085163 | Redwood Community Services, Inc. | Case Management | 7690 East Rd, Redwood Valley, CA 95470 | 2017-07-14 |
| 1477075067 | Redwood Community Services, Inc. | Case Management | 150 Gibson St, Ukiah, CA 95482-3941 | 2017-07-14 |
| 1285187526 | Redwood Community Services, Inc. | Case Management | 9981 Spring Valley Rd, Potter Valley, CA 95469-9713 | 2016-08-03 |
| Street Address |
810 N STATE ST |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-3410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023434362 | Bonnie Lockhart | Counselor | 810 N State St, Ukiah, CA 95482-3410 | 2014-03-11 |
| 1639738792 | Marla Boelter | Counselor | 810 N State St, Ukiah, CA 95482-3410 | 2019-06-11 |
| 1992282495 | Hiedi White | Counselor | 810 N State St, Ukiah, CA 95482-3410 | 2018-07-26 |
| 1760969232 | Kristen Lawson | Counselor | 810 N State St, Ukiah, CA 95482-3410 | 2018-07-26 |
| 1790262459 | Savannah Koppenhaver | Counselor | 810 N State St, Ukiah, CA 95482-3410 | 2018-07-25 |
| 1447744636 | Theresa Silsbee | Counselor | 810 N State St, Ukiah, CA 95482-3410 | 2018-06-20 |
| 1275044695 | Alexis Gonzalez | Counselor | 810 N State St, Ukiah, CA 95482 | 2017-10-12 |
| 1891239968 | Kimberly Mallory | Counselor | 810 N State St, Ukiah, CA 95482-3410 | 2016-12-08 |
| 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 |
| Find all providers in zip 95482 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1558702795 | Redwood Community Services, Inc | Community/Behavioral Health | 800 N. State Street, (rcs - Mffa / Tfc), Ukiah, CA 95482 | 2013-07-16 |
| 1972776904 | Tapestry Family Services, Inc. | Community/Behavioral Health | 201a E Gobbi St, Ukiah, CA 95482-5513 | 2008-04-10 |
| 1770705139 | Couty of Mendocino | Community/Behavioral Health | 1011 Low Gap Road, Ukiah, CA 95482 | 2007-05-03 |
| 1932242310 | Tapestry Family Services | Community/Behavioral Health | 3800 Low Gap Rd, Ukiah, CA 95482-3740 | 2007-02-15 |
| 1932241833 | Tapestry Family Services | Community/Behavioral Health | 169 Mason St Ste 300, Ukiah, CA 95482-4483 | 2007-02-14 |
| 1265858575 | County of Mendocino | Community/Behavioral Health | 727 S. State Street, Ukiah, CA 95482-5815 | 2014-03-11 |
| 1508296989 | Tapestry Family Services | Community/Behavioral Health | 1011 Low Gap Road, Ukiah, CA 95482 | 2013-11-20 |
| 1831523091 | Manzanita Services Inc. | Community/Behavioral Health | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2013-08-23 |
| 1477985091 | County of Mendocino | Community/Behavioral Health | 727 S State St, Ukiah, CA 95482-5815 | 2013-08-06 |
| Find all providers in UKIAH | ||||
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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.