CHANGING TIDES FAMILY SERVICES (NPI# 1992338669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992338669 |
| Entity Type | Organization |
| Organization Name | CHANGING TIDES FAMILY SERVICES |
| Practice Address |
2257 Myrtle Ave Eureka CA 95501-3486 |
| Mailing Address |
2259 Myrtle Ave Eureka CA 95501-3325 |
| Practice Telephone | 7074448293 |
| Practice Fax Number | 7074448298 |
| Mailing Telephone | 7074448293 |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2020-02-20 |
| Authorized Official Name | CONNIE SUNDBERG (FAMILY EMPOWERMENT SERVICES DIRECTO) |
| Authorized Official Telephone | 7074448293 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336489202 | Changing Tides Family Services | Community/Behavioral Health | 2259 Myrtle Ave, Eureka, CA 95501-3325 | 2013-02-28 |
| 1336453505 | Changing Tides Family Services | Community/Behavioral Health | 3300 Glenwood St, Eureka, CA 95501-3463 | 2010-07-30 |
| 1871628578 | Changing Tides Family Services | Community/Behavioral Health | 2259 Myrtle Ave, Eureka, CA 95501-3325 | 2007-02-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CHANGING TIDES FAMILY SERVICES | 2259 Myrtele Ave, Eureka, CA 95501-3325 |
| Street Address |
2257 MYRTLE AVE |
| City | EUREKA |
| State | CA |
| Zip Code | 95501-3486 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366751166 | Karly Quinn Mertz | Counselor | 2257 Myrtle Ave, Eureka, CA 95501-3486 | 2010-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538795919 | Eric Meyer Goldsmith | Physical Therapist | 2306 Dean Street, Eureka, CA 95501 | 2020-03-18 |
| 1609406404 | Humboldt County Behavioral Health | Community/Behavioral Health | 638 W Clark St., Bldg. E, Eureka, CA 95501 | 2020-01-21 |
| 1740831767 | Jacqueline Renee Coghill | Nurse Practitioner | Waterfront Recovery Services, 2413 2nd St, Eureka, CA 95501 | 2019-09-20 |
| 1982177275 | Jenny Bugnacki | Case Manager/Care Coordinator | 721 Wood St, Eureka, CA 95501 | 2019-01-09 |
| 1073023107 | Humboldt Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 1303 11th St, Eureka, CA 95501 | 2017-10-03 |
| 1730698283 | Gabriel Holtski | Naturopath | 1632 Broadway, Suite #252, Eureka, CA 95501 | 2017-09-27 |
| 1164951851 | Redwood Community Services, Inc. | Foster Care Agency | 2426 6th St, Eureka, CA 95501 | 2017-06-07 |
| 1033651922 | Narum Clinical Services | Social Worker | 930 3rd St, Suite 201, Eureka, CA 95501 | 2016-11-09 |
| 1750839510 | Sierra Marie Evers-hellmich | Physical Medicine & Rehabilitation | 2103 Myrtle Avenue, Eureka, CA 95501 | 2016-09-21 |
| 1558720623 | Jennifer Vu | Behavioral Analyst | 730 7th St Ste A, Eureka, CA 95501 | 2016-02-18 |
| Find all providers in zip 95501 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720604226 | Healing Journey Psychiatry Pllc | Community/Behavioral Health | 99 Mills Spring Rd Ste 6, Eureka, MT 59917-9773 | 2020-06-19 |
| 1609406404 | Humboldt County Behavioral Health | Community/Behavioral Health | 638 W Clark St., Bldg. E, Eureka, CA 95501 | 2020-01-21 |
| 1083266886 | Humboldt County Behavioral Health | Community/Behavioral Health | 2944 D St, Eureka, CA 95501-4349 | 2019-07-11 |
| 1619441615 | County of Humboldt | Community/Behavioral Health | 2004 Harrison Ave Rm 3-4, Eureka, CA 95501-3212 | 2019-01-14 |
| 1134464316 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 101 S. Major Street, Eureka, IL 61530 | 2012-11-29 |
| 1811267917 | Humboldt County Behavioral Health | Community/Behavioral Health | 550 I St, Eureka, CA 95501-1117 | 2012-01-05 |
| 1134353402 | Humboldt County Mental Health | Community/Behavioral Health | 638 West Clark Street, Eureka, CA 95501 | 2009-05-14 |
| 1063657666 | Humboldt County Behavioral Health | Community/Behavioral Health | 231 2nd St, Eureka, CA 95501-0319 | 2008-12-10 |
| 1477763225 | The Redwood Family Institute | Community/Behavioral Health | 935 3rd St, Eureka, CA 95501-0513 | 2007-05-23 |
| 1003024449 | Making Headway Center for Brain Injury Recovery | Community/Behavioral Health | 730 K St, Eureka, CA 95501-1123 | 2007-05-18 |
| Find all providers in EUREKA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.