Organization
GREAT VALLEY ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS ANDERSON M.A. (SUPERINTENDENT/CEO)
(209) 876-9446
Entity
Organization
Contact information
Practice address
3200 TULLY RD, MODESTO, CA 95350-0811
(209) 876-9446
Mailing address
3200 TULLY RD, MODESTO, CA 95350-0811
(209) 876-9446
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
Primary
—
—
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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