NPIMap

Organization Active NPI

Campobello Chemical Dependency Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Santa Rosa, CA
National Provider Identifier
1144343138
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
490002AP Issued in CA
Legal business name
CAMPOBELLO CHEMICAL DEPENDENCY RECOVERY CENTER
Practice address
3250 Guerneville Rd
Santa Rosa, CA 95401-4030
Phone
(707) 579-4066
Fax
(707) 579-1603
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Authorized official

Name
William L Twitchell, CPA
Title
Owner Ceo
Phone
(707) 284-1235

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 490002AP CA Primary

Addresses

Primary practice location

3250 Guerneville Rd
Santa Rosa, CA 95401-4030

Mailing address

PO Box 4869
Santa Rosa, CA 95402-4869
Phone (707) 284-1235

National Provider Directory

National Provider Directory

Locations

3250 Guerneville Rd
Santa Rosa, CA 95401
Phone (707) 579-4066

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1144343138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4869",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954024869",
            "telephone_number": "707-284-1235",
            "fax_number": "707-284-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 GUERNEVILLE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014030",
            "telephone_number": "707-579-4066",
            "fax_number": "707-579-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPOBELLO CHEMICAL DEPENDENCY RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "TWITCHELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "707-284-1235",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "490002AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.