Organization
LIVING WELL BCS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI LYNN MIKLUSICAK (DIRECTOR)
(209) 968-9080
Entity
Organization
Contact information
Practice address
510 CHABOT AVE, MODESTO, CA 95354-0233
(209) 968-9080
Mailing address
510 CHABOT AVE, MODESTO, CA 95354-0233
(209) 968-9080
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/21/2013
Last updated
02/21/2013
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