| |
1601 I St., Ste. 200, 2nd Fl. Modesto CA 95354-1110 | |
(209) 525-6225 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 1601 I St., Ste. 200, 2nd Fl., Modesto, California |
Authorized Official Name and Position | Tony Vartan (BEHAVIORAL HEALTH DIRECTOR) |
Authorized Official Contact | 2095256225 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1601 I St., Ste. 200, 2nd Fl. Modesto CA 95354-1110 Ph: (209) 525-6225 | 1601 I St., Ste. 200, 2nd Fl. Modesto CA 95354-1110 Ph: (209) 525-6225 |
NPI Number | 1831227974 |
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Provider Enumeration Date | 03/01/2007 |
Last Update Date | 10/03/2024 |
Certification Date | 10/03/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831227974 | NPI | - | NPPES |
ZZZ21961Z | Other | MEDICARE ID | |
5000 | Medicaid | CA | |
ZZZ93575Z | Other | MEDICARE |
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 | |