NPIMap

Organization Active NPI

Manzanita Services, Inc.

  • Community/Behavioral Health Agency
  • Willits, CA
National Provider Identifier
1235566480
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MANZANITA SERVICES, INC.
Practice address
286 School St
Willits, CA 95490-3435
Phone
(707) 463-0405
NPI assigned
Oct 2, 2013
Last updated
Oct 2, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
MANZANITA SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Authorized official

Name
Susan Wynd NovotnyNPI 1417382813
Title
Executive Director
Phone
(707) 463-0405

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

286 School St
Willits, CA 95490-3435

Mailing address

PO Box 1424
Ukiah, CA 95482-1424
Phone (707) 972-9040

National Provider Directory

National Provider Directory
Tax ID family
Manzanita Services Inc2 organizations share this tax ID, including this one
Part of
Manzanita Services Inc

Other organizations with this tax ID 1

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

Locations

286 School St
Willits, CA 95490
Phone (707) 456-9020

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1235566480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1424",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954821424",
            "telephone_number": "707-972-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 SCHOOL ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954903435",
            "telephone_number": "707-463-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANZANITA SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANZANITA SERVICES, INC.",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "NOVOTNY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "WYND",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-463-0405"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willits, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.