| Detention Services | |
|
200 E Hackett Rd Modesto CA 95358-9415 | |
| (209) 525-6225 | |
| Not Available |
| Full Name | Detention Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 200 E Hackett Rd, 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 |
|---|---|
| Detention Services 800 Scenic Dr Modesto CA 95350-6131 Ph: (209) 525-6225 | Detention Services 200 E Hackett Rd Modesto CA 95358-9415 Ph: (209) 525-6225 |
| NPI Number | 1740318807 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 10/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740318807 | NPI | - | NPPES |
| 5031 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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