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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