| Valley Teen Ranch | |
|
10641 Road 35 Madera CA 93636 | |
| (559) 437-1444 | |
| Not Available |
| Full Name | Valley Teen Ranch |
|---|---|
| Speciality | Contractor - Home Modifications |
| Location | 10641 Road 35, Madera, California |
| Authorized Official Name and Position | Andrea Michele Evans (CEO) |
| Authorized Official Contact | 5594371144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Teen Ranch 2610 W Shaw Ln Ste 105 Fresno CA 93711-2775 Ph: (559) 437-1144 | Valley Teen Ranch 10641 Road 35 Madera CA 93636 Ph: (559) 437-1444 |
| NPI Number | 1730851320 |
|---|---|
| Provider Enumeration Date | 10/01/2021 |
| Last Update Date | 05/06/2025 |
| Certification Date | 05/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730851320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| 171WH0202X | Contractor - Home Modifications | (* (Not Available)) | Primary |
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