Provider Demographics
NPI:1164010567
Name:SEVENTH GENERATION HOUSE, INC
Entity Type:Organization
Organization Name:SEVENTH GENERATION HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:BRENARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-683-5201
Mailing Address - Street 1:269 BRENARD RD
Mailing Address - Street 2:
Mailing Address - City:LOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:95551-9701
Mailing Address - Country:US
Mailing Address - Phone:707-392-3780
Mailing Address - Fax:
Practice Address - Street 1:2575 TODD CT
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-5147
Practice Address - Country:US
Practice Address - Phone:707-392-3780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-02
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility