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Organization
REDWOOD COMMUNITY SERVICES, INC.
Active
Organization
REDWOOD COMMUNITY SERVICES, INC.
Active
Parent organization
REDWOOD COMMUNITY SERVICES, INC
Other names
RCS Behavioral Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
REDWOOD COMMUNITY SERVICES, INC
Authorized official
MRS. VICTORIA JERUSHA KELLY LCSW (CHIEF EXECUTIVE OFFCIER)
(707) 467-2010
Entity
Organization
Contact information
Practice address
32670 HIGHWAY 20 UNIT 2, FORT BRAGG, CA 95437-5708
(707) 964-1136
(707) 964-4558
Mailing address
PO BOX 422, 780 S. DORA ST., UKIAH, CA 95482-0422
(707) 467-2010
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23CJ
MENDOCINO COUNTY PROVIDER NUMBER
CA
01
—
67958
CITY OF FORT BRAGG - BUISNESS LICENSE
CA
Enumeration date
12/19/2011
Last updated
01/21/2020
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