| Organization Name: | CRESTWOOD BEHAVIORAL HEALTH, INC. |
| NPI Number: | 1750452199 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORI BLACKBURN (VICE PRESIDENT) |
| Mailing Address: | 2201 Tuolumne St Vallejo |
| State: | CA US |
| Postal Code: | 945892524 |
| Phone Number: | 7075581777 |
| Fax Number: | 7075581770 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 05/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320800000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |