| Peach Tree Yuba County Probation | |
|
120 5th St Rm 1 Marysville CA 95901-5734 | |
| (530) 749-3242 | |
| (530) 749-3248 |
| Full Name | Peach Tree Yuba County Probation |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 5th St Rm 1, Marysville, California |
| Authorized Official Name and Position | Greg Scott Stone (CEO) |
| Authorized Official Contact | 5307416245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peach Tree Yuba County Probation 1114 Yuba St Ste 220 Marysville CA 95901-4838 Ph: (530) 749-3242 | Peach Tree Yuba County Probation 120 5th St Rm 1 Marysville CA 95901-5734 Ph: (530) 749-3242 |
| NPI Number | 1114643871 |
|---|---|
| Provider Enumeration Date | 10/14/2022 |
| Last Update Date | 11/08/2022 |
| Medicare PECOS PAC ID | 7416978440 |
|---|---|
| Medicare Enrollment ID | O20221222001936 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114643871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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