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 |
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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 |
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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 |
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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 |
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 | |