Organization
COUNTY OF MERCED
Active
Other names
Marie Green Psychiatric Healthcare Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT CRAIG MIPP/US (COMPLIANCE OFFICER)
(209) 381-6818
Entity
Organization
Contact information
Practice address
300 E 15TH ST STE B, MERCED, CA 95341-6217
(209) 381-6879
Mailing address
P.O. BOX 2087, MERCED, CA 95344-0087
(209) 381-6800
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
106244027
CA
283Q00000X
Psychiatric Hospital
Primary
—
CA
283Q00000X
Psychiatric Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2415
—
CA
Enumeration date
04/09/2007
Last updated
08/27/2019
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