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830 E Minnesota Ave Turlock CA 95382-1510 | |
| (209) 216-0101 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 830 E Minnesota Ave, Turlock, California |
| Authorized Official Name and Position | Stacey Bronken (QUALITY ASSURANCE COORDINATOR) |
| Authorized Official Contact | 2095234610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
100 Poplar Ave Modesto CA 95354-0510 Ph: (209) 523-4573 | 830 E Minnesota Ave Turlock CA 95382-1510 Ph: (209) 216-0101 |
| NPI Number | 1952433906 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 11/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952433906 | NPI | - | NPPES |
| 50AU | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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