Organization
MHN GOVERNMENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY MAYNARD (PRESIDENT & CEO)
(916) 353-6100
Entity
Organization
Contact information
Practice address
344 PENDLETON WAY, OAKLAND, CA 94621-2102
(510) 430-3640
(510) 430-3683
Mailing address
2025 AEROJET RD, RANCHO CORDOVA, CA 95742-6418
(916) 353-6100
(916) 353-6809
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
01-006-01-120
CA
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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