# CRESTWOOD BEHAVIORAL HEALTH, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CRESTWOOD MANOR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508884487
- **Authorized official:** MICHELLE SMITH (EXECUTIVE DIRECTOR REIMBURSEMENT)
- **Authorized official phone:** (209) 955-2364

## Contact information

- **Practice address:** 1400 CELESTE DR, MODESTO, CA 95355-5041
- **Practice address phone:** (209) 526-8050
- **Practice address fax:** (209) 523-0652
- **Mailing address:** 7590 SHORELINE DR, STOCKTON, CA 95219-5455
- **Mailing address phone:** (209) 955-2328
- **Mailing address fax:** (209) 952-5314

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 05/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR18515H | — | CA |