Butler Valley # 2

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

LTC60133F Issued in CA

Legal business name

BUTLER VALLEY # 2

Practice address

3971 F St
Eureka, CA 95503-6003

Phone

(707) 442-7313

NPI assigned

Nov 28, 2007

Organization subpart

Yes

Parent organization

BUTLER VALLEY INCORPORATEDAs reported in NPPES

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

Authorized official

Name

Suzette Ott

Title

Executive Director

Phone

(707) 442-2451

Specialties & licenses 1

Addresses

Tax ID family

Butler Valley2 organizations share this tax ID, including this one

Part of

Butler Valley

Other organizations with this tax ID 1

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

• Butler Valley

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Arcata, CA
  • NPI 1043492358
  NPD tax ID

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1700068111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 VANCE ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955036350",
            "telephone_number": "707-442-2451",
            "fax_number": "707-445-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3971 F ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955036003",
            "telephone_number": "707-442-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTLER VALLEY # 2",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BUTLER VALLEY INCORPORATED",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "SUZETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-442-2451"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC60133F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Burton, MD
• Robert Burton III
• Bridget Marion Bush, SAC
• Larry Butcher
• Marcia Deana Butler Smith, RN
• Breanne Maura Butler-Smith
• Gary Butler II, CRNP
• Jason Allen Butler, M.A.
• Wendy Butler
• Terri Ellen Butts, LCSW

• Intellectual Disabilities Intermediate Care Facility in Eureka, CA
• Providers in Eureka, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.