Organization
GOSPEL CENTER RESCUE MISSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA ANN MAPLE-DEAVER (RECUPERATIVE CARE DIRECTOR)
(209) 320-2327
Entity
Organization
Contact information
Practice address
445 S SAN JOAQUIN ST, STOCKTON, CA 95203-3537
(209) 466-2138
(209) 466-4927
Mailing address
445 S SAN JOAQUIN ST, STOCKTON, CA 95203-3537
(209) 466-2138
(209) 466-4927
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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