| State Health Care Dual Diagnosis | |
|
4042 S Demaree St Visalia CA 93277-9476 | |
| (310) 628-9512 | |
| (818) 392-5025 |
| Full Name | State Health Care Dual Diagnosis |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4042 S Demaree St, Visalia, California |
| Authorized Official Name and Position | Edna Elizabeth Miller (PRESIDENT) |
| Authorized Official Contact | 3106289512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Health Care Dual Diagnosis 19300 Rinaldi St Northridge CA 91326-1651 Ph: (310) 628-9512 | State Health Care Dual Diagnosis 4042 S Demaree St Visalia CA 93277-9476 Ph: (310) 628-9512 |
| NPI Number | 1043265044 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043265044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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