Organization
CRESTWOOD BEHAVIORAL HEALTH, INC.
Active
Parent organization
CRESTWOOD BEHAVIORAL HEALTH,INC.
Other names
Cordilleras Health & Healing Ponderosa House
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRESTWOOD BEHAVIORAL HEALTH,INC.
Authorized official
MICHELLE SMITH (EXECUTIVE DIRECTOR AR REIMB.)
(209) 955-2364
Entity
Organization
Contact information
Practice address
280 EDMONDS ROAD, BLDG B, REDWOOD CITY, CA 94062
(209) 955-2364
(209) 671-1520
Mailing address
7590 SHORELINE DR, STOCKTON, CA 95219-5455
(209) 955-2316
(209) 671-1520
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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