Provider Demographics
NPI:1699150243
Name:REDWOOD COMMUNITY SERVICES, INC.
Entity type:Organization
Organization Name:REDWOOD COMMUNITY SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:707-472-2922
Mailing Address - Street 1:800 NORTH STATE STREET
Mailing Address - Street 2:PO BOX 422
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5348
Mailing Address - Country:US
Mailing Address - Phone:707-467-2010
Mailing Address - Fax:707-462-6994
Practice Address - Street 1:800 N STATE ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-3410
Practice Address - Country:US
Practice Address - Phone:707-468-5536
Practice Address - Fax:707-467-9034
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REDWOOD COMMUNITY SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-24
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency