# CRESTWOOD BEHAVIORAL HEALTH INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CRESTWOOD BEHAVIORAL HEALTH INC
- **Other names:** CRESTWOOD MANOR-FREMONT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902828403
- **Legal business name:** CRESTWOOD BEHAVIORAL HEALTH INC
- **Authorized official:** MICHELLE SMITH (EXECUTIVE DIRECTOR REIMBURSEMENT)
- **Authorized official phone:** (209) 955-2364

## Contact information

- **Practice address:** 4303 STEVENSON BLVD, FREMONT, CA 94538-2645
- **Practice address phone:** (510) 651-1244
- **Practice address fax:** (510) 651-1127
- **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:** 07/24/2006
- **Last updated:** 05/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC90080F | — | CA |