| Crestwood Crisis Stabilization Services | |
|
2101 Courage Dr Fairfield CA 94533 | |
| (209) 955-2328 | |
| (209) 644-5721 |
| Full Name | Crestwood Crisis Stabilization Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2101 Courage Dr, Fairfield, California |
| Authorized Official Name and Position | Lori Blackburn (CAO/TREASURER) |
| Authorized Official Contact | 2099552322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestwood Crisis Stabilization Services 7590 Shoreline Dr Stockton CA 95219-5455 Ph: (209) 955-2328 | Crestwood Crisis Stabilization Services 2101 Courage Dr Fairfield CA 94533 Ph: (209) 955-2328 |
| NPI Number | 1972095701 |
|---|---|
| Provider Enumeration Date | 06/06/2018 |
| Last Update Date | 06/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972095701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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