Blackwell Homes

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

496800053 Issued in CA

Legal business name

BLACKWELL HOMES

Practice address

1646 S Wright Rd
Santa Rosa, CA 95407-7318

Phone

(707) 575-5387

Fax

(707) 570-2647

NPI assigned

Jan 26, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Willard Blackwell, MA

Title

Cfo

Phone

(707) 575-5387

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264464000000",
    "number": "1700117082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8578",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954071578",
            "telephone_number": "707-575-5387",
            "fax_number": "707-570-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1646 S WRIGHT RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077318",
            "telephone_number": "707-575-5387",
            "fax_number": "707-570-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKWELL HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-01-26",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "WILLARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "707-575-5387",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "CA",
            "license": "496800053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BKD Arbors of Santa Rosa, LLC (Brookdale Chanate)
• Bruce Black, PSYCH TECH
• Denise Black
• Kate Esther Black, MD
• Delbert Lee Blackburn
• Bradley Thomas Blackwell
• Benjamin William Blair, R1499800323
• Christine Linda Blake, RPT
• Eylin Margarita Blake, AMFT
• Katie Blake, LCSW

• Developmental Disabilities Clinic/Center in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Developmental Disabilities Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.