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PROMESA BEHAVIORAL HEALTH- MILLBROOK NPI 1962997221


NPI Information

NPI: 1962997221
Provider Name: PROMESA BEHAVIORAL HEALTH- MILLBROOK
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
4291 N MILLBROOK AVE
FRESNO, CA
ZIP 93726
Phone: (559) 439-5437
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PROMESA BEHAVIORAL HEALTH- MILLBROOK is a community based residential treatment facility mental illness in Fresno, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. PROMESA BEHAVIORAL HEALTH- MILLBROOK NPI is 1962997221. The provider is registered as an organization entity type.

The provider's business location address is:

4291 N MILLBROOK AVE
FRESNO, CA
ZIP 93726
Phone: (559) 439-5437

The provider's authorized official is Amanda Irene Reed .
The authorized official title is Director and has the following contact phone number (559) 439-5437.

The enumeration date for this NPI number is 6/28/2018 and was last updated on 8/13/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental Illness107201149CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1101044MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.