STATE HEALTH CARE DUAL DIAGNOSIS NPI 1689884595

NPI Information

STATE HEALTH CARE DUAL DIAGNOSIS is a rehabilitation and substance use disorder clinic center in Fresno, CA. STATE HEALTH CARE DUAL DIAGNOSIS NPI is 1689884595. The provider is registered as an organization entity type.
The provider Is Doing Business As State Health Care Dual Diagnosis.

The provider's business location address is:

1145 W HEDGES AVE
FRESNO, CA
ZIP 93728-219
Phone: (310) 628-9512
Fax: (818) 804-4047

The provider's authorized official is Edna Miller .
The authorized official title is President and has the following contact phone number (310) 628-9512.

The enumeration date for this NPI number is 5/23/2007 and was last updated on 8/22/2020.

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:

Other Identifiers

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

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