Organization
CAMPOBELLO CHEMICAL DEPENDENCY RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM L TWITCHELL CPA (OWNER CEO)
(707) 284-1235
Entity
Organization
Contact information
Practice address
3250 GUERNEVILLE RD, SANTA ROSA, CA 95401-4030
(707) 579-4066
(707) 579-1603
Mailing address
PO BOX 4869, SANTA ROSA, CA 95402-4869
(707) 284-1235
(707) 284-1236
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
490002AP
CA
Other
Enumeration date
04/06/2007
Last updated
02/17/2011
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