|
| |
|
800 Scenic Dr Modesto CA 95350-6131 | |
| (209) 525-6011 | |
| (209) 558-4351 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 800 Scenic Dr, Modesto, California |
| Authorized Official Name and Position | Ruben Imperial (BEHAVIORAL HEALTH INTERIM DIRECTOR) |
| Authorized Official Contact | 2095256225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
800 Scenic Dr Modesto CA 95350-6131 Ph: (209) 525-6225 | 800 Scenic Dr Modesto CA 95350-6131 Ph: (209) 525-6011 |
| NPI Number | 1053444877 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 10/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053444877 | NPI | - | NPPES |
| 50BG | Other | CA | MEDICAID - STATE PROVIDER NUMBER |
| 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 | |