| Childrens Crisis Intervention Program | |
|
1540 Florida Ave Ste 212 Modesto CA 95350-4430 | |
| (209) 661-8840 | |
| (209) 661-4843 |
| Full Name | Childrens Crisis Intervention Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1540 Florida Ave Ste 212, Modesto, California |
| Authorized Official Name and Position | Vernon Brown (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6508664080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Crisis Intervention Program 400 Oyster Point Blvd Suite 501 South San Francisco CA 94080-1904 Ph: (650) 866-4080 | Childrens Crisis Intervention Program 1540 Florida Ave Ste 212 Modesto CA 95350-4430 Ph: (209) 661-8840 |
| NPI Number | 1356798383 |
|---|---|
| Provider Enumeration Date | 05/19/2016 |
| Last Update Date | 10/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356798383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 415200481 (California) | Primary |
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