Butler Valley

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

LTC60058F Issued in CA

Legal business name

BUTLER VALLEY

Practice address

380 12TH St
Arcata, CA 95521-5914

Phone

(707) 822-0301

NPI assigned

Nov 28, 2007

Organization subpart

Yes

Parent organization

BUTLER VALLEY INCORPORATEDAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Suzette Ott

Title

Executive Director

Phone

(707) 442-2451

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G102

Legal name

BUTLER VALLEY

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Sep 14, 1983

Last certification

Oct 22, 2025

Beds

6

Ownership / control type

Private (non-profit)

Facility address

380 12TH Street
Arcata, CA 95521

Tax ID family

Butler Valley2 organizations share this tax ID, including this one

Part of

Butler Valley

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Butler Valley # 2

  • Intellectual Disabilities Intermediate Care Facility
  • Eureka, CA
  • NPI 1700068111
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1043492358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 VANCE ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955036350",
            "telephone_number": "707-442-2451",
            "fax_number": "707-445-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 12TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215914",
            "telephone_number": "707-822-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTLER VALLEY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BUTLER VALLEY INCORPORATED",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "SUZETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-442-2451"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "LTC60058F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willow Burns
• Kristen Heather Burrell, RN
• Debra Felice Burstiner, OTR
• Mehgan Burton
• Gerald Busby
• Viktoria Walda Byczkiewicz, PH.D.
• Emily Caffrey
• Shane Calhoun, PSY.D.
• California Em-I Medical Services, a Medical Corporation
• California State Polytechnic University, Humboldt

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arcata, CA
• Providers in Arcata, CA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.