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Organization
READY TO WORK
Active
Organization
READY TO WORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLAA ELIZABETH MARTIN (EXECUTIVE DIRECTOR)
(209) 423-5082
Entity
Organization
Contact information
Practice address
20 N SUTTER ST STE 203, STOCKTON, CA 95202-2911
(209) 423-5082
Mailing address
119 E WEBER AVE, STOCKTON, CA 95202-2704
(209) 423-5082
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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