Organization
COMMUNITY RE-ORGANIZATION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRIS CLAY (DIRECTOR OF CRP)
(209) 946-3733
Entity
Organization
Contact information
Practice address
3601 PACIFIC AVE, STOCKTON, CA 95211
(209) 346-3733
Mailing address
3601 PACIFIC AVE, STOCKTON, CA 95211
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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