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Organization
MODESTO GOSPEL MISSION
Active
Organization
MODESTO GOSPEL MISSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON ALLEN CONWAY (CEO)
(209) 225-2905
Entity
Organization
Contact information
Practice address
1400 YOSEMITE BLVD, MODESTO, CA 95354-2840
(209) 529-8259
Mailing address
PO BOX 1203, MODESTO, CA 95353-1203
(529) 225-2905
(209) 529-3450
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/07/2022
Last updated
07/29/2025
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