NPIMap

Organization Active NPI

Redwood Community Services, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Ukiah, CA
National Provider Identifier
1174778674
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
REDWOOD COMMUNITY SERVICES, INC
Practice address
150 Gibson St
Ukiah, CA 95482-3941
Phone
(707) 462-4770
NPI assigned
Nov 25, 2008
Last updated
Jun 8, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
REDWOOD COMMUNITY SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Mrs. Victoria Jerusha Kelly, LCSWNPI 1801125844
Title
Chief Executive Officer
Phone
(707) 467-2010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU
Early Intervention Provider Agency 252Y00000X NU
Foster Care Agency 253J00000X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

150 Gibson St
Ukiah, CA 95482-3941

Mailing address

PO Box 2077
631 S. Orchard St
Ukiah, CA 95482-2077
Phone (707) 467-2010

Other practice location 1

9981 Spring Valley Rd
Potter Valley, CA 95469-9713
Phone (707) 743-1537

Other identifiers 1

IdentifierTypeStateIssuer
23BVOtherCAMH SITE CERT - MENDOCINO COUNTY MH

Other names 1

  • Mendocino House Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160908002886 CA Part B Supplier - Clinic/Group Practice 7618263187 Receives reassigned benefits from 11 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ukiah, CA; Upper Lake, CA; Willits, CA; Redwood Valley, CA; Fort Bragg, CA; Lakeport, CA

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Redwood Community Services29 organizations share this tax ID, including this one
Part of
Redwood Community Services

Other organizations with this tax ID 28

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

View all 28

Locations

780 S Dora St
Ukiah, CA 95482
Phone (707) 462-9784

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1174778674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "address_2": "631 S. ORCHARD ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954822077",
            "telephone_number": "707-467-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GIBSON ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954823941",
            "telephone_number": "707-462-4770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9981 Spring Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Potter Valley",
            "state": "CA",
            "postal_code": "954699713",
            "country_code": "US",
            "telephone_number": "707-743-1537",
            "fax_number": "707-743-1495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REDWOOD COMMUNITY SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REDWOOD COMMUNITY SERVICES, INC",
        "enumeration_date": "2008-11-25",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "JERUSHA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-467-2010",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MH SITE CERT - MENDOCINO COUNTY MH",
            "identifier": "23BV",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mendocino House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.