NPIMap

Organization Active NPI

Crestwood Behavioral Health Inc.

Doing business as Crestwood Manor

  • Long Term Care Hospital
  • Vallejo, CA
National Provider Identifier
1144390964
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
110000044 Issued in CA
Legal business name
CRESTWOOD BEHAVIORAL HEALTH INC.
Doing business as
Crestwood Manor
Practice address
115 Oddstad Dr
Vallejo, CA 94589-2520
Phone
(707) 552-0215
Fax
(707) 553-2161
NPI assigned
Nov 9, 2006
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Michelle Smith
Title
Executive Director Ar and Reimb.
Phone
(209) 955-2364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 110000044 CA Primary

Addresses

Primary practice location

115 Oddstad Dr
Vallejo, CA 94589-2520

Mailing address

115 Oddstad Dr
Vallejo, CA 94589-2520
Phone (707) 552-0215

Other names 1

  • CRESTWOOD MANOR Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crestwood PHF Sacramento71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1144390964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ODDSTAD DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892520",
            "telephone_number": "707-552-0215",
            "fax_number": "707-553-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ODDSTAD DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892520",
            "telephone_number": "707-552-0215",
            "fax_number": "707-553-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD BEHAVIORAL HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR AR AND REIMB.",
        "authorized_official_telephone_number": "209-955-2364"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "CA",
            "license": "110000044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRESTWOOD MANOR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CRESTWOOD MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.