NPIMap

Organization Active NPI

Drug Abuse Alternatives Center

Doing business as Redwood Empire Addiction Program

  • Methadone Clinic
  • Santa Rosa, CA
National Provider Identifier
1629289152
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
DRUG ABUSE ALTERNATIVES CENTER
Doing business as
Redwood Empire Addiction Program
Practice address
2403 Professional Dr
Suite 103
Santa Rosa, CA 95403-3007
Phone
(707) 526-2999
Fax
(707) 526-0527
NPI assigned
May 25, 2007
Last updated
Dec 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Authorized official

Name
Mr. John Challis
Title
Center Point Vice President Daac
Phone
(415) 526-2943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

2403 Professional Dr
Suite 103
Santa Rosa, CA 95403-3007

Mailing address

2403 Professional Dr
Suite 102
Santa Rosa, CA 95403-3007
Phone (707) 571-2233

Other names 1

  • Redwood Empire Addiction Program Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Opioid treatment program
Medicare-enrolled since Feb 4, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200429001289 CA Part B Supplier - Opioid Treatment Program (Otp) 2668802943 1 other NPI on this enrollment
Practice locations: Santa Rosa, CA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Drug Abuse Alternatives Ctr10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

2403 Professional Dr
Ste 103
Santa Rosa, CA 95403
Phone (707) 526-2999

Practitioners & affiliated clinicians

Practitioners 57

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 57

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1629289152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 PROFESSIONAL DR",
            "address_2": "SUITE 102",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033007",
            "telephone_number": "707-571-2233",
            "fax_number": "707-571-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 PROFESSIONAL DR",
            "address_2": "SUITE 103",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033007",
            "telephone_number": "707-526-2999",
            "fax_number": "707-526-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRUG ABUSE ALTERNATIVES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "CHALLIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CENTER POINT VICE PRESIDENT DAAC",
        "authorized_official_telephone_number": "415-526-2943",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redwood Empire Addiction Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 7, 2015; 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.