| Canyon Manor Residential Tx Center | |
|
655 Canyon Rd Novato CA 94947-4331 | |
| (209) 525-7423 | |
| Not Available |
| Full Name | Canyon Manor Residential Tx Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 655 Canyon Rd, Novato, California |
| Authorized Official Name and Position | Denise C Hunt (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 2095256225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Manor Residential Tx Center 800 Scenic Dr Modesto CA 95350-6131 Ph: () - | Canyon Manor Residential Tx Center 655 Canyon Rd Novato CA 94947-4331 Ph: (209) 525-7423 |
| NPI Number | 1134251176 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134251176 | NPI | - | NPPES |
| 50AG | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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