NPIMap

Organization Active NPI

Redwood Community Services, Inc.

  • Community/Behavioral Health Agency
  • Ukiah, CA
National Provider Identifier
1477075067
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
REDWOOD COMMUNITY SERVICES, INC.
Practice address
150 Gibson St
Ukiah, CA 95482-3941
Phone
(707) 462-4770
NPI assigned
Jul 14, 2017
Last updated
Dec 10, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
REDWOOD COMMUNITY SERVCIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

150 Gibson St
Ukiah, CA 95482-3941

Mailing address

PO Box 2077
Ukiah, CA 95482-2077
Phone (707) 467-2010

Other names 1

  • Gibson House Other name

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1477075067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954822077",
            "telephone_number": "707-467-2010",
            "fax_number": "707-462-6994"
        },
        {
            "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": [],
    "basic": {
        "organization_name": "REDWOOD COMMUNITY SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REDWOOD COMMUNITY SERVCIES",
        "enumeration_date": "2017-07-14",
        "last_updated": "2020-12-10",
        "certification_date": "2020-11-30",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gibson 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 Dec 10, 2020; 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.