NPIMap

Organization Active NPI

Manzanita Services Inc.

  • Community/Behavioral Health Agency
  • Ukiah, CA
National Provider Identifier
1831523091
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MANZANITA SERVICES INC.
Practice address
410 Jones St Ste C1
Ukiah, CA 95482-5491
Phone
(707) 463-0405
Fax
(707) 313-4999
NPI assigned
Aug 23, 2013
Last updated
Mar 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Ms. Susan Wynd Novotny, BA MHRSNPI 1417382813
Title
Executive Director
Phone
(707) 972-9040

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 Primary

Addresses

Primary practice location

410 Jones St Ste C1
Ukiah, CA 95482-5491

Mailing address

PO Box 1424
Ukiah, CA 95482-1424
Phone (707) 463-0405

National Provider Directory

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

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 43

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 43

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1831523091",
    "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": "707-463-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 JONES ST STE C1",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825491",
            "telephone_number": "707-463-0405",
            "fax_number": "707-313-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANZANITA SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-23",
        "last_updated": "2016-03-08",
        "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": "707-972-9040",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BA MHRS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 8, 2016; 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.