| Grant House | |
|
1117 S Grant Street Stockton CA 95206 | |
| (209) 461-6500 | |
| (209) 461-6543 |
| Full Name | Grant House |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1117 S Grant Street, Stockton, California |
| Authorized Official Name and Position | Nzinga Harrison (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 9258254700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant House 3480 Buskirk Ave Ste 300 Pleasant Hill CA 94523-4343 Ph: (925) 825-4700 | Grant House 1117 S Grant Street Stockton CA 95206 Ph: (209) 461-6500 |
| NPI Number | 1568686830 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 07/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568686830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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