| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 801 11th St, Modesto, California |
| Authorized Official Name and Position | Ruben Imperial (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 2095256225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
800 Scenic Dr Modesto CA 95350-6131 Ph: (209) 525-6225 | 801 11th St Modesto CA 95354-2348 Ph: (209) 567-4120 |
| NPI Number | 1659404879 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 07/27/2020 |
| Certification Date | 07/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659404879 | NPI | - | NPPES |
| 505013 | Other | CA | CALOMS NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Golden Valley Health Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 6th St, Modesto, CA 95354 Phone: 209-576-2845 Fax: 209-384-3966 | |
Golden Valley Health Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1717 Las Vegas St, Modesto, CA 95358 Phone: 209-576-4200 Fax: 209-384-3966 | |