Organization
COUNTY OF MERCED
Active
Other names
BHRS YOUTH OUTPATIENT- LOS BANOS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT CRAIG CIPP/US (COMPLIANCE OFFICER)
(209) 381-6818
Entity
Organization
Contact information
Practice address
40 W G ST STE A-E, LOS BANOS, CA 93635-3657
(209) 710-6100
Mailing address
P.O. BOX 2087, MERCED, CA 95344-0087
(209) 381-6800
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2453
—
CA
Enumeration date
04/09/2007
Last updated
08/08/2019
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