Mh-willow Hs | |
1650 Crockett Blvd Crockett CA 94525-1444 | |
(510) 787-1286 | |
(510) 787-2184 |
Full Name | Mh-willow Hs |
---|---|
Speciality | Community/behavioral Health |
Location | 1650 Crockett Blvd, Crockett, California |
Authorized Official Name and Position | Donald Bruce Blasky (CHIEF PROGRAM OFFICER) |
Authorized Official Contact | 4157552311 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mh-willow Hs 11175 San Pablo Ave El Cerrito CA 94530-2157 Ph: (510) 559-3009 | Mh-willow Hs 1650 Crockett Blvd Crockett CA 94525-1444 Ph: (510) 787-1286 |
NPI Number | 1780241349 |
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Provider Enumeration Date | 05/20/2019 |
Last Update Date | 08/02/2021 |
Certification Date | 08/02/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780241349 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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