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800 Scenic Dr Modesto CA 95350-6131 | |
(209) 525-6225 | |
Not Available |
Full Name | |
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Speciality | Community/Behavioral Health |
Location | 800 Scenic Dr, Modesto, California |
Authorized Official Name and Position | Ruben Imperial (BEHAVIORAL HEALTH INTERIM DIRECTOR) |
Authorized Official Contact | 2095256225 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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800 Scenic Dr Modesto CA 95350-6131 Ph: (209) 525-6225 | 800 Scenic Dr Modesto CA 95350-6131 Ph: (209) 525-6225 |
NPI Number | 1043411762 |
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Provider Enumeration Date | 05/30/2007 |
Last Update Date | 02/24/2020 |
Certification Date | 02/24/2020 |
Medicare PECOS PAC ID | 0648183996 |
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Medicare Enrollment ID | O20200227000883 |
Identifier | Type | State | Issuer |
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1043411762 | NPI | - | NPPES |
5014 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (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 | |