NPIMap

Organization Active NPI

Friend of Boon

  • Recovery Care Clinic/Center
  • Ukiah, CA
National Provider Identifier
1134953045
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recovery Care Clinic/CenterTaxonomy code 261QR0800X
Legal business name
FRIEND OF BOON
Practice address
527 S State St
Ukiah, CA 95482-4910
Phone
(707) 672-6153
NPI assigned
Sep 2, 2024
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Sidney BurgessNPI 1124825609
Title
President
Phone
(707) 672-6153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Recovery Care Clinic/Center 261QR0800X Primary
Non-emergency Medical Transport (VAN) 343900000X
In Home Supportive Care Agency 253Z00000X
Local Education Agency (LEA) 251300000X

Addresses

Primary practice location

527 S State St
Ukiah, CA 95482-4910

Mailing address

500 Cochrane Ave
Ukiah, CA 95482-5621
Phone (707) 672-6153

National Provider Directory

National Provider Directory

Locations

527 S State St
Ukiah, CA 95482
Phone (707) 672-6153

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1134953045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COCHRANE AVE",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825621",
            "telephone_number": "707-672-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 S STATE ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824910",
            "telephone_number": "707-672-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIEND OF BOON",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-672-6153"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 22, 2024; 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.