Organization
COUNTY OF STANISLAUS
Active
Organization
COUNTY OF STANISLAUS
Active
Parent organization
COUNTY OF STANISLAUS
Other names
Juvenile Justice - CSOC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF STANISLAUS
Authorized official
RUBEN IMPERIAL MBA (BEHAVIORAL HEALTH DIRECTOR)
(209) 525-6225
Entity
Organization
Contact information
Practice address
2215 BLUE GUM AVE, MODESTO, CA 95358-1052
(209) 525-6225
Mailing address
800 SCENIC DRIVE, BLDG. 4, MODESTO, CA 95350-6131
(209) 525-6225
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5048
—
CA
Enumeration date
03/01/2007
Last updated
03/10/2022
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