Organization
COUNTY OF STANISLAUS
Active
Other names
Sonoma School CCS MTU
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN LEE (MANAGING DIRECTOR, HEALTH SERVICES)
(209) 558-7163
Entity
Organization
Contact information
Practice address
1325 SONOMA AVE, MODESTO, CA 95355-3922
(209) 558-8118
(209) 558-8620
Mailing address
PO BOX 3088, MODESTO, CA 95353-3088
(209) 558-8118
(209) 558-8620
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
CCS00057F
CA
Other
Enumeration date
11/07/2006
Last updated
05/20/2010
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