| Crestwood Behavioral Health, Inc. | |
|
1945 Kidder Ave Fairfield CA 94533-3919 | |
| (707) 421-8242 | |
| Not Available |
| Full Name | Crestwood Behavioral Health, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1945 Kidder Ave, Fairfield, California |
| Authorized Official Name and Position | Michelle Smith (EXECUTIVE DIRECTOR AR AND REIMB.) |
| Authorized Official Contact | 2099552364 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestwood Behavioral Health, Inc. 7590 Shoreline Dr Stockton CA 95219-5455 Ph: (209) 955-2328 | Crestwood Behavioral Health, Inc. 1945 Kidder Ave Fairfield CA 94533-3919 Ph: (707) 421-8242 |
| NPI Number | 1073648747 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 11/30/2023 |
| Certification Date | 11/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073648747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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