| Redwood Community Services, Inc. | |
|
160 S Main St Lakeport CA 95453 | |
| (707) 263-0372 | |
| Not Available |
| Full Name | Redwood Community Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 160 S Main St, Lakeport, California |
| Authorized Official Name and Position | Victoria Jerusha Kelly (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7074672010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Redwood Community Services, Inc. Po Box 2077 631 S. Orchard Street Ukiah CA 95482-2077 Ph: (707) 467-2010 | Redwood Community Services, Inc. 160 S Main St Lakeport CA 95453 Ph: (707) 263-0372 |
| NPI Number | 1891859047 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 01/13/2020 |
| Certification Date | 01/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891859047 | NPI | - | NPPES |
| 01164707 | Medicaid | CA | |
| 49EC1 | Other | CA | SONOMA CO PROVIDER NO |
| 01816207 | Medicaid | CA | |
| 5878 | Other | CA | SUTTER-YUBA CO PROVIDER NO |
| 1791 | Other | CA | LAKE CO. MH SITE # |
| 0851 | Other | CA | DEL NORTE CO PROVIDER NO |
| 27A7 | Other | CA | NAPA CO SITE # |
| 01726307 | Medicaid | CA | |
| 2377 | Other | MENDOCINO CO. PROVIDER NO. |
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