Provider Demographics
NPI:1437551652
Name:WILLITS HOSPITAL INC
Entity Type:Organization
Organization Name:WILLITS HOSPITAL INC
Other - Org Name:ADVENTIST HEALTH HOWARD MEMORIAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-456-3010
Mailing Address - Street 1:PO BOX 888828
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-8828
Mailing Address - Country:US
Mailing Address - Phone:707-459-6115
Mailing Address - Fax:707-459-1345
Practice Address - Street 1:3 MARCELA DR
Practice Address - Street 2:
Practice Address - City:WILLITS
Practice Address - State:CA
Practice Address - Zip Code:95490-5769
Practice Address - Country:US
Practice Address - Phone:707-459-6115
Practice Address - Fax:707-459-1345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058680Medicare Oscar/Certification