Provider Demographics
NPI:1053478354
Name:THE LOYD WOLFE JUVENILE NETWORK
Entity Type:Organization
Organization Name:THE LOYD WOLFE JUVENILE NETWORK
Other - Org Name:WOLFE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OF THE BOARD
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-255-1855
Mailing Address - Street 1:2310 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2239
Mailing Address - Country:US
Mailing Address - Phone:707-255-1855
Mailing Address - Fax:
Practice Address - Street 1:2310 1ST ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2239
Practice Address - Country:US
Practice Address - Phone:707-255-1855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health