| Svcfs - 50173, 50174 | |
|
1700 Mchenry Village Way Suite 13, 14 & 16 Modesto CA 95350-4308 | |
| (209) 527-3270 | |
| Not Available |
| Full Name | Svcfs - 50173, 50174 |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1700 Mchenry Village Way, Modesto, 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 |
|---|---|
| Svcfs - 50173, 50174 1700 Mchenry Village Way Suite 13, 14 & 16 Modesto CA 95350-4308 Ph: (209) 527-3270 | Svcfs - 50173, 50174 1700 Mchenry Village Way Suite 13, 14 & 16 Modesto CA 95350-4308 Ph: (209) 527-3270 |
| NPI Number | 1558494740 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558494740 | NPI | - | NPPES |
| 50AA | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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