Provider Demographics
NPI:1467608745
Name:JANUS OF SANTA CRUZ
Entity Type:Organization
Organization Name:JANUS OF SANTA CRUZ
Other - Org Name:RESIDENTIAL TREATMENT CENTER AND SPECIAL CARE UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-278-7906
Mailing Address - Street 1:200 7TH AVENUE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4668
Mailing Address - Country:US
Mailing Address - Phone:831-462-1060
Mailing Address - Fax:831-462-4970
Practice Address - Street 1:200 7TH AVE STE 150
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4669
Practice Address - Country:US
Practice Address - Phone:831-462-1060
Practice Address - Fax:831-462-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440003EN251S00000X, 261QR0405X
251S00000X, 261QM0801X, 261QM0850X, 261QM0855X, 261QR0405X, 276400000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4410Medicaid
CA440003BNOtherDHCS
CA440003ANOtherDHCS