Organization
FRESNO COUNTY ADOLESCENT DAY TREATMENT (ADT- EDT)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA SUE TAYLOR R,.N. (INTERIM DEPUTY DIRECTOR)
(559) 453-5798
Entity
Organization
Contact information
Practice address
3133 N MILLBROOK AVE, FRESNO, CA 93703-1425
(559) 453-8918
Mailing address
3133 N MILLBROOK AVE, FRESNO, CA 93703-1425
(559) 453-8918
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2240
COST CENTER
—
Enumeration date
03/02/2007
Last updated
08/22/2020
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