# COUNTY OF STANISLAUS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sonoma School CCS MTU
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679642060
- **Authorized official:** MARYANN LEE (MANAGING DIRECTOR, HEALTH SERVICES)
- **Authorized official phone:** (209) 558-7163

## Contact information

- **Practice address:** 1325 SONOMA AVE, MODESTO, CA 95355-3922
- **Practice address phone:** (209) 558-8118
- **Practice address fax:** (209) 558-8620
- **Mailing address:** PO BOX 3088, MODESTO, CA 95353-3088
- **Mailing address phone:** (209) 558-8118
- **Mailing address fax:** (209) 558-8620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | CCS00057F | CA | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 05/20/2010