| Department Of Alcohol And Drug Services-central Valley Clinic | |
|
2425 Enborg Ln San Jose CA 95128-2648 | |
| (408) 885-5400 | |
| Not Available |
| Full Name | Department Of Alcohol And Drug Services-central Valley Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2425 Enborg Ln, San Jose, California |
| Authorized Official Name and Position | Robert Garner (DEPARTMENT DIRECTOR) |
| Authorized Official Contact | 4087925680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Department Of Alcohol And Drug Services-central Valley Clinic 976 Lenzen Ave 3rd Floor San Jose CA 95126-2737 Ph: (408) 792-5680 | Department Of Alcohol And Drug Services-central Valley Clinic 2425 Enborg Ln San Jose CA 95128-2648 Ph: (408) 885-5400 |
| NPI Number | 1912041922 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1254244973 |
|---|---|
| Medicare Enrollment ID | O20201214001191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912041922 | NPI | - | NPPES |
| 434397 | Other | CA | STATE PROVIDER NUMBER |
| 4397 | Other | CA | DRUG MEDI-CAL NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM2800X | Clinic/center - Methadone | (* (Not Available)) | Primary |
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