| Transitional Age Youth Program | |
|
2719 N Air Fresno Dr Fresno CA 93727-1547 | |
| (559) 600-6853 | |
| Not Available |
| Full Name | Transitional Age Youth Program |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2719 N Air Fresno Dr, Fresno, California |
| Authorized Official Name and Position | Susan L Holt (DIRECTOR) |
| Authorized Official Contact | 5596009058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transitional Age Youth Program 4441 E Kings Canyon Rd Fresno CA 93702-3604 Ph: (559) 600-9193 | Transitional Age Youth Program 2719 N Air Fresno Dr Fresno CA 93727-1547 Ph: (559) 600-6853 |
| NPI Number | 1205213139 |
|---|---|
| Provider Enumeration Date | 04/29/2015 |
| Last Update Date | 09/16/2022 |
| Certification Date | 09/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205213139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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