| Mental Health Modesto Llc | |
|
1101 Standiford Ave Ste D4 Modesto CA 95350-0981 | |
| (201) 306-5670 | |
| Not Available |
| Full Name | Mental Health Modesto Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1101 Standiford Ave Ste D4, Modesto, California |
| Authorized Official Name and Position | Sophie Gomes (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2013065670 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Modesto Llc 2915 Red Hill Ave Ste A210c Costa Mesa CA 92626-7979 Ph: () - | Mental Health Modesto Llc 1101 Standiford Ave Ste D4 Modesto CA 95350-0981 Ph: (201) 306-5670 |
| NPI Number | 1629826276 |
|---|---|
| Provider Enumeration Date | 05/08/2024 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629826276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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