| Svcfs-home Based Services | |
|
1700 Mchenry Village Way Modesto CA 95350-4308 | |
| (209) 550-5865 | |
| Not Available |
| Full Name | Svcfs-home Based Services |
|---|---|
| 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-home Based Services 100 Poplar Ave Modesto CA 95354-0510 Ph: (209) 523-4573 | Svcfs-home Based Services 1700 Mchenry Village Way Modesto CA 95350-4308 Ph: (209) 550-5865 |
| NPI Number | 1326259821 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326259821 | NPI | - | NPPES |
| 5093 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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