Provider Demographics
NPI:1902247786
Name:REDWOOD QUALITY MANAGEMENT COMPANY, INC.
Entity Type:Organization
Organization Name:REDWOOD QUALITY MANAGEMENT COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:BERT
Authorized Official - Last Name:SCHRAEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:707-472-0350
Mailing Address - Street 1:PO BOX 1449
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-1449
Mailing Address - Country:US
Mailing Address - Phone:707-472-0350
Mailing Address - Fax:707-472-0358
Practice Address - Street 1:350 E GOBBI ST STE B
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5511
Practice Address - Country:US
Practice Address - Phone:707-472-0350
Practice Address - Fax:070-472-0358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01857OtherLEGAL ENTITY NUMBER
CA23C7OtherMENDOCINO CO. SITE CERTIFICATION NUMBER