NPIMap

Organization Active NPI

Ford Street Project

Doing business as Ukiah Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Ukiah, CA
National Provider Identifier
1073946547
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
230004AN Issued in CA
Legal business name
FORD STREET PROJECT
Doing business as
Ukiah Recovery Center
Practice address
201 Brush St
Ukiah, CA 95482-3424
Phone
(707) 462-1934
Fax
(707) 468-9860
NPI assigned
Aug 19, 2013
Last updated
May 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Authorized official

Name
Ms. Jacqueline Williams
Title
Executive Director
Phone
(707) 462-1934

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 230004AN CA Primary

Addresses

Primary practice location

201 Brush St
Ukiah, CA 95482-3424

Mailing address

139 Ford St
Ukiah, CA 95482-4011
Phone (707) 462-1934

Other names 1

  • Ukiah Recovery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ford Street Project2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

139 Ford St
Ukiah, CA 95482
Phone (707) 462-1934

201 Brush St
Ukiah, CA 95482
Phone (707) 462-1934

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1073946547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 FORD ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824011",
            "telephone_number": "707-462-1934",
            "fax_number": "707-468-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BRUSH ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954823424",
            "telephone_number": "707-462-1934",
            "fax_number": "707-468-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORD STREET PROJECT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-462-1934",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "230004AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ukiah Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ukiah Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.