Organization
CRESTWOOD BEHAVIORAL HEALTH, INC.
Active
Other names
CRESTWOOD MANOR
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE SMITH (EXECUTIVE DIRECTOR REIMBURSEMENT)
(209) 955-2364
Entity
Organization
Contact information
Practice address
115 ODDSTAD DR, VALLEJO, CA 94589-2520
(707) 552-0215
(707) 553-2161
Mailing address
7590 SHORELINE DR, STOCKTON, CA 95219-5455
(209) 955-2328
(209) 478-3717
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR18025H
—
CA
Enumeration date
07/18/2006
Last updated
05/20/2025
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