Organization
BOYS & GIRLS CLUBS OF STANISLAUS COUNTY
Active
Other names
Boys & Girls Clubs of Stanislaus County
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY JAMES MARTINEZ MPA, CCMC (CEO)
(209) 222-5826
Entity
Organization
Contact information
Practice address
819 17TH ST, MODESTO, CA 95354-1250
(209) 222-5826
Mailing address
819 17TH ST, MODESTO, CA 95354-1250
(209) 222-5826
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251X00000X
Supports Brokerage Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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