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Organization
DEPARTMENT OF HEALTH SERVICES
Active
Organization
DEPARTMENT OF HEALTH SERVICES
Active
Other names
DMH Creative Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA STORNETTA (COMPLIANCE AUDITOR ACCOUNTANT III)
(707) 565-4782
Entity
Organization
Contact information
Practice address
617 W 9TH ST, SANTA ROSA, CA 95401-5438
(707) 565-4850
Mailing address
617 W 9TH ST, SANTA ROSA, CA 95401-5438
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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