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Organization

CHAMBERLAIN'S YOUTH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELANIE MARIE DAVIS LCSW (DIR. MENTAL HEALTH SERVICES)
(831) 636-2121
Entity
Organization

Contact information

Practice address
1850 SAN BENITO ST, HOLLISTER, CA 95023-4899
(831) 636-2121
(831) 636-5296
Mailing address
1850 SAN BENITO ST, HOLLISTER, CA 95023-4899
(831) 636-2121
(831) 636-5296

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
355201170
CA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility

Other

Enumeration date
11/12/2014
Last updated
03/21/2019
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