Sonoma Recovery Services, LLC
Substance Abuse Rehabilitation Facility in Petaluma, CA. Organization (NPI-2).
NPI number1760732002
StatusActive
Last updated in NPPESSep 13, 2012
Details
- NPI
- 1760732002
- Entity type
- Organization (NPI-2)
- Legal business name
- Sonoma Recovery Services, LLC
- Organization subpart
- No
- Enumeration date
- Sep 13, 2012
- Last updated
- Sep 13, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | – | CA | Yes |
Other names
- Olympia House (Other Name)
Practice location
11207 Valley Ford RdPetaluma, CA 94952-3700
Phone 707-795-7609
Mailing address
11207 Valley Ford RdPetaluma, CA 94952-3700
Phone 707-795-7609
Authorized official
Wayne C Thurston
Managing Member/Executive Director
7077957609
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