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Organization
PANACEA, INC.
Active
Organization
PANACEA, INC.
Active
Parent organization
PANACEA SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PANACEA SERVICES, INC.
Authorized official
MR. PHILLIP COWINGS (DIRECTOR)
(559) 241-0364
Entity
Organization
Contact information
Practice address
3152 N MILLBROOK AVE STE D, FRESNO, CA 93703-1459
(559) 241-0364
Mailing address
3152 N MILLBROOK AVE STE D, FRESNO, CA 93703-1459
(559) 241-0364
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MEDI-CAL
343444000
CA
Enumeration date
12/01/2006
Last updated
11/08/2018
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