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90 W Ashlan Ave Clovis CA 93612-5627 | |
| (559) 326-5696 | |
| (559) 326-5699 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 90 W Ashlan Ave, Clovis, California |
| Authorized Official Name and Position | Vernon Brown (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6508664080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1320 E Shaw Ave Ste 140 Fresno CA 93710-7905 Ph: (559) 326-5696 | 90 W Ashlan Ave Clovis CA 93612-5627 Ph: (559) 326-5696 |
| NPI Number | 1851153795 |
|---|---|
| Provider Enumeration Date | 01/25/2024 |
| Last Update Date | 01/23/2025 |
| Certification Date | 01/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851153795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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