Organization
PACIFIC VALLEY RECOVERY CENTER INCORPORATED
Active
Other names
N/A
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLSIE RUTH HUDSON (CEO/DIRECTOR OF PROGRAMS)
(209) 817-5720
Entity
Organization
Contact information
Practice address
820 E MAIN ST, STOCKTON, CA 95202-3129
(209) 817-5720
Mailing address
2491 BURLINGTON PL, STOCKTON, CA 95209-4029
(209) 817-5720
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
390030AN
CA
Other
Enumeration date
08/20/2007
Last updated
08/20/2007
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