| Nirvana Prop 36 Op | |
|
948 11th St Modesto CA 95354-2308 | |
| (209) 579-1103 | |
| Not Available |
| Full Name | Nirvana Prop 36 Op |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 948 11th St, Modesto, California |
| Authorized Official Name and Position | Denise C Hunt (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 2095256225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nirvana Prop 36 Op 800 Scenic Dr Modesto CA 95350-6131 Ph: () - | Nirvana Prop 36 Op 948 11th St Modesto CA 95354-2308 Ph: (209) 579-1103 |
| NPI Number | 1770616088 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770616088 | NPI | - | NPPES |
| 5033 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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