Provider Demographics
NPI:1801614680
Name:COMMON PURPOSE
Entity type:Organization
Organization Name:COMMON PURPOSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:III
Authorized Official - Credentials:SUDCC III
Authorized Official - Phone:530-274-2000
Mailing Address - Street 1:256 BUENA VISTA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-7239
Mailing Address - Country:US
Mailing Address - Phone:530-274-2000
Mailing Address - Fax:530-274-2116
Practice Address - Street 1:145 BOST AVE
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-3249
Practice Address - Country:US
Practice Address - Phone:530-274-2000
Practice Address - Fax:530-274-2116
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMON PURPOSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251B00000XAgenciesCase Management