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Organization
COUNTY OF STANISLAUS
Active
Organization
COUNTY OF STANISLAUS
Active
Other names
Sonoma School CCS MTU
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN LEE (MANAGING DIRECTOR, HEALTH SERVICES)
(209) 558-7163
Entity
Organization
Contact information
Practice address
1325 SONOMA AVE, MODESTO, CA 95355-3922
(209) 558-8118
(209) 558-8620
Mailing address
PO BOX 3088, MODESTO, CA 95353-3088
(209) 558-8118
(209) 558-8620
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
CCS00057F
CA
Other
Enumeration date
11/07/2006
Last updated
05/20/2010
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