Organization Name: | FORD STREET PROJECT |
NPI Number: | 1073946547 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACQUELINE WILLIAMS (EXECUTIVE DIRECTOR) |
Mailing Address: | 201 Brush St Ukiah |
State: | CA US |
Postal Code: | 954823424 |
Phone Number: | 7074621934 |
Fax Number: | 7074689860 |
NPI Enumeration Date: | 08/19/2013 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 324500000X |
License Number: | 230004AN |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |