Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 1418 J St, 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 |
---|---|
1601 I St., Ste. 200, 2nd Fl. Modesto CA 95354-1110 Ph: (209) 525-6225 | 1418 J St Modesto CA 95354-1013 Ph: (209) 558-8302 |
NPI Number | 1639208820 |
---|---|
Provider Enumeration Date | 03/05/2007 |
Last Update Date | 05/01/2024 |
Certification Date | 02/05/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639208820 | NPI | - | NPPES |
50AS | Medicaid | CA |
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 | |