First Street Center Outpatient Ab 109 | |
3636 N 1st St Suite 135 And 154 Fresno CA 93726-6800 | |
(559) 225-1464 | |
(559) 225-1693 |
Full Name | First Street Center Outpatient Ab 109 |
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Speciality | Community/behavioral Health |
Location | 3636 N 1st St, Fresno, California |
Authorized Official Name and Position | Sharon Marie Ross (CHIEF OPERATING OFFICER) |
Authorized Official Contact | 5597328086 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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First Street Center Outpatient Ab 109 Po Box 7447 Visalia CA 93290-7447 Ph: (559) 732-8086 | First Street Center Outpatient Ab 109 3636 N 1st St Suite 135 And 154 Fresno CA 93726-6800 Ph: (559) 225-1464 |
NPI Number | 1013265859 |
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Provider Enumeration Date | 08/28/2012 |
Last Update Date | 01/03/2023 |
Certification Date | 01/03/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013265859 | NPI | - | NPPES |
10ED | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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