Provider Demographics
NPI:1336824572
Name:MUIR WOOD LLC
Entity type:Organization
Organization Name:MUIR WOOD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF PAYOR STRATEGY
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:STRATFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-566-5518
Mailing Address - Street 1:1733 SKILLMAN LN
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-1250
Mailing Address - Country:US
Mailing Address - Phone:855-684-7966
Mailing Address - Fax:707-559-5401
Practice Address - Street 1:2225 DA VINCI DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-5501
Practice Address - Country:US
Practice Address - Phone:310-903-1155
Practice Address - Fax:707-559-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children