Provider Demographics
NPI:1205025970
Name:SEVEN FOLDS
Entity Type:Organization
Organization Name:SEVEN FOLDS
Other - Org Name:NA
Other - Org Type:Other Name
Authorized Official - Title/Position:CENTER DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:661-631-8415
Mailing Address - Street 1:201 4TH ST STE 702
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-2346
Mailing Address - Country:US
Mailing Address - Phone:661-631-8415
Mailing Address - Fax:661-326-1602
Practice Address - Street 1:201 4TH ST STE 702
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-2346
Practice Address - Country:US
Practice Address - Phone:661-631-8415
Practice Address - Fax:661-326-1602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150040AN3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1562OtherMED-CAL