Organization
MEDMARK TREATMENT CENTERS - STOCKTON, INC.
Active
Parent organization
MEDMARK SERVICES, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDMARK SERVICES, INC
Authorized official
BRUCE JARVIE (VP, TREASURER)
(214) 379-3300
Entity
Organization
Contact information
Practice address
1111 N EL DORADO STREET, STOCKTON, CA 95202-1305
(209) 938-0228
(209) 938-0281
Mailing address
1720 LAKEPOINTE DR STE 117, LEWISVILLE, TX 75057-6425
(214) 379-3300
(214) 853-9018
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
39-07
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48-AC
—
CA
01
—
48AC
MEDI-CAL
CA
Enumeration date
12/15/2006
Last updated
07/29/2024
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