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Organization
MARY MAGDALENE COMMUNITY SERVICES AGENCY
Active
Organization
MARY MAGDALENE COMMUNITY SERVICES AGENCY
Active
Other names
Mary Magdalene Community Services, Mary Magdalene Community Services Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENEVA HAYNES (EXECUTIVE DIRECTOR)
(209) 888-4519
Entity
Organization
Contact information
Practice address
620 N AURORA ST STE 7, STOCKTON, CA 95202-2276
(209) 888-4519
Mailing address
620 N AURORA ST STE 7, STOCKTON, CA 95202-2276
(209) 888-4519
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
163WC0400X
Case Management Registered Nurse
—
—
Other
Enumeration date
03/27/2023
Last updated
09/12/2023
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