Organization
CRESTWOOD BEHAVIORAL HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE SMITH LPT (EXECUTIVE DIRECTOR REIMBURSEMENT)
(209) 955-2364
Entity
Organization
Contact information
Practice address
482 AZTEC LN, LATHROP, CA 95330-9142
(209) 922-9902
Mailing address
482 AZTEC LN, LATHROP, CA 95330-9142
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
LP36472
CA
314000000X
Skilled Nursing Facility
LP36472
CA
Other
Enumeration date
08/28/2012
Last updated
09/16/2025
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