Provider Demographics
NPI:1417637935
Name:YELLOW WOOD RECOVERY INC
Entity Type:Organization
Organization Name:YELLOW WOOD RECOVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-238-6070
Mailing Address - Street 1:2969 PROSPECT PARK DR STE 225
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6188
Mailing Address - Country:US
Mailing Address - Phone:916-820-4747
Mailing Address - Fax:916-238-6070
Practice Address - Street 1:2969 PROSPECT PARK DR STE 225
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6188
Practice Address - Country:US
Practice Address - Phone:916-238-6070
Practice Address - Fax:916-238-6070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility