Organization
DEPARTMENT OF HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA L. STORNETTA (ACCOUNTANT III COMPLIANCE)
(707) 565-4782
Entity
Organization
Contact information
Practice address
1430 NEOTOMAS AVE, SANTA ROSA, CA 95405-7575
(707) 565-7450
Mailing address
1430 NEOTOMAS AVE, SANTA ROSA, CA 95405-7575
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/23/2007
Last updated
08/22/2020
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