Organization
CRESTWOOD BEHAVIORAL HEALTH, INC.
Active
Other names
Crestwood Youth Enhanced Short-Term Residential Therapeutic Program
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE SMITH (EXECUTIVE DIRECTOR REIMBURSEMENT)
(209) 955-2364
Entity
Organization
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(209) 955-2316
Mailing address
7590 SHORELINE DR, STOCKTON, CA 95219-5455
(209) 955-2316
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/12/2026
Last updated
06/12/2026
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