SUBSTANCE USE DISORDERS TREATMENT - NEW BEGINNINGS (COUNTY OF MENDOCINO) NPI 1649468968

Community/Behavioral Health in Ukiah, CA

NPI 1649468968 Organization Community/Behavioral Health

About SUBSTANCE USE DISORDERS TREATMENT - NEW BEGINNINGS (COUNTY OF MENDOCINO)

Substance Use Disorders Treatment - New Beginnings (county Of Mendocino) is a provider established in Ukiah, California specializing in community/behavioral health. The NPI number of Substance Use Disorders Treatment - New Beginnings (county Of Mendocino) is 1649468968 and was assigned on October 2007. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The provider's other name is Substance Use Disorders Treatment - New Beginnings. The authorized official of this NPI record is Jenine Miller Psy.d. (Bhrs Deputy Director)

NPI

1649468968

Provider NameSUBSTANCE USE DISORDERS TREATMENT - NEW BEGINNINGS (COUNTY OF MENDOCINO)
Provider Location Address518 LOW GAP RD UKIAH, CA 95482
Provider Mailing Address1120 S DORA ST UKIAH, CA 95482
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameSUBSTANCE USE DISORDERS TREATMENT - NEW BEGINNINGS
Other Name TypeOther Name (5)
Enumeration Date10-11-2007
Last Update Date07-01-2014


Primary Taxonomy

Taxonomy Code251S00000X
ClassificationCommunity/Behavioral Health
TypeAgencies
Taxonomy DescriptionA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Business Address

SUBSTANCE USE DISORDERS TREATMENT - NEW BEGINNINGS
518 LOW GAP RD
UKIAH, CA
ZIP 95482
Phone: (707) 472-2637
Fax: (707) 472-2657

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Mailing Address

SUBSTANCE USE DISORDERS TREATMENT - NEW BEGINNINGS
1120 S DORA ST
UKIAH, CA
ZIP 95482
Phone: (707) 472-2637
Fax: (707) 472-2657



Authorized Official

Authorized Official Name JENINE MILLER PSY.D.
Authorized Official TitleBHRS DEPUTY DIRECTOR
Authorized Official Phone(707) 472-2637

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1251K00000XAgenciesPublic Health or WelfareNo

Taxonomy Description: Not Available

2261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, FederalNo

Taxonomy Description: Not Available

3261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or LocalNo

Taxonomy Description: Not Available

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
2305MEDICAID (05)CA
2305OTHER (01)CA

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1497961015 KATHRYN KELLY FEIGIN
Individual
Counselor (Addiction (Substance Use Disorder))518 LOW GAP RD
UKIAH, CA 95482
(707) 467-6012
1003005190 ANDREA ROAD-TRAVELER LONGORIA
Individual
Case Manager/Care Coordinator518 LOW GAP RD
UKIAH, CA 95482
(707) 463-4968
1003062209 GEMA J PEREZ
Individual
Case Manager/Care Coordinator518 LOW GAP RD
UKIAH, CA 95482
(707) 467-6411
1710016829COUNTY OF MENDOCINO
Organization
Clinic/Center (Adolescent and Children Mental Health)518 LOW GAP RD
UKIAH, CA 95482
(707) 472-2300

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.