| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1275 B Street, Merced, California |
| Authorized Official Name and Position | Kurt Craig (COMPLIANCE OFFICER) |
| Authorized Official Contact | 2093816818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
P.o. Box 2087 Merced CA 95344 Ph: (209) 381-6800 | 1275 B Street Merced CA 95341 Ph: (209) 381-6800 |
| NPI Number | 1023139516 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 08/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023139516 | NPI | - | NPPES |
| 2467 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
Life Center Of America Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1057 N St, Merced, CA 95341 Phone: 209-384-9547 | |
Marie Green Psychiatric Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 452 Hydrangea Ct, Merced, CA 95341 Phone: 209-777-2233 | |
The Bridge, J. Stanley Bunce, Ph.d., & Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 Park Avenue, Merced, CA 95348 Phone: 209-384-0414 Fax: 209-384-1562 | |