Organization
COUNTY OF STANISLAUS
Active
Parent organization
COUNTY OF STANISLAUS
Other names
Medication Clinic - Child
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF STANISLAUS
Authorized official
RUBEN IMPERIAL MBA (BEHAVIORAL HEALTH DIRECTOR)
(209) 525-6225
Entity
Organization
Contact information
Practice address
101 PARK AVE, MODESTO, CA 95354-0556
(209) 558-7494
Mailing address
1601 I ST., STE. 200, 2ND FL., MODESTO, CA 95354-1110
(209) 525-6225
(209) 558-4326
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50AB
—
CA
Enumeration date
03/05/2007
Last updated
08/07/2025
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