Organization
BHRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA ANN MORENO BA (MSW INTERN)
(559) 443-9220
Entity
Organization
Contact information
Practice address
1550 W MAIN ST, RIPON, CA 95366
(209) 341-0718
Mailing address
1904 RICHMOND AVE, CERES, CA 95307-7507
(209) 541-2077
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
CA
Other
Enumeration date
10/21/2008
Last updated
10/01/2009
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