| |
1501 Claus Rd Modesto CA 95355-9711 | |
(209) 558-4700 | |
Not Available |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 1501 Claus Rd, Modesto, California |
Authorized Official Name and Position | Greg Berry (CFO) |
Authorized Official Contact | 2095763790 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 57376 Los Angeles CA 90074-7377 Ph: () - | 1501 Claus Rd Modesto CA 95355-9711 Ph: (209) 558-4700 |
NPI Number | 1548399736 |
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Provider Enumeration Date | 03/05/2007 |
Last Update Date | 03/23/2022 |
Certification Date | 03/23/2022 |
Medicare PECOS PAC ID | 5496649915 |
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Medicare Enrollment ID | O20070608000288 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548399736 | NPI | - | NPPES |
HSP40464H | Medicaid | CA | |
5036 | Medicaid | CA | |
HSC30464H | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
273R00000X | Psychiatric Unit | (* (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 | |