Santa Rosa Treatment Program, Inc.
LBN: Santa Rosa Treatment Program, Inc.
Santa Rosa Treatment Program, Inc. is an health care organization with primary practice located at 625 Steele Lane , Santa Rosa CA 95403-3127. The organization recently has only one registered license in Ambulatory Health Care Facilities / Methadone, which is considered as the primary health care specialty.
Santa Rosa Treatment Program, Inc. can be contacted via phone (707) 576-0818, or through Tillman, Lee Roy via phone (707) 576-0818.
Contact Information
Primary practice address
625 Steele Lane
Santa Rosa CA 95403-3127
Phone: (707) 576-0818
Fax: (707) 576-7845
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Methadone | 261QM2800X | 49-02 | California |
Profile Details
| NPI number | 1285631978 |
|---|---|
| LBN Legal business name | Santa Rosa Treatment Program, Inc. |
| DBA Doing business as | |
| Authorized official | Tillman, Lee Roy |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Mar 7th, 2023 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285631978 | NPPES |
| California | Other | 3631909 | EDD STATE PROVIDER |
| California | Other | CA-10228-M | EDD STATE PROVIDER |
| California | Other | 49-02 | EDD STATE PROVIDER |
| California | MEDICAID | 49AC | EDD STATE PROVIDER |
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