Provider Demographics
NPI:1003073446
Name:NAPA VALLEY PROJECT NINETY INC.
Entity Type:Organization
Organization Name:NAPA VALLEY PROJECT NINETY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ED
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SABIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-579-7881
Mailing Address - Street 1:2100 NAPA VALLEJO HWY
Mailing Address - Street 2:M-1 M-2
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6234
Mailing Address - Country:US
Mailing Address - Phone:707-603-1112
Mailing Address - Fax:
Practice Address - Street 1:2100 NAPA VALLEJO HWY
Practice Address - Street 2:M-1 M-2
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6234
Practice Address - Country:US
Practice Address - Phone:707-603-1112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROJECT NINETY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA280014AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility