NPI: 1720299175
Provider Name: STATE HEALTH CARE DUAL DIAGNOSIS PROGRAM
Doing Business As: STATE HEALTH CARE DUAL DIAGNOSIS PROGRAM
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization
Specialization: Rehabilitation, Substance Use Disorder
Address:
1145 W HEDGES AVE
SUITE B
FRESNO, CA
ZIP 93728
Phone: (310) 628-9512
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STATE HEALTH CARE DUAL DIAGNOSIS PROGRAM is a rehabilitation and substance use disorder clinic center in Fresno, CA. STATE HEALTH CARE DUAL DIAGNOSIS PROGRAM NPI is 1720299175. The provider is registered as an organization entity type.
The provider Is Doing Business As State Health Care Dual Diagnosis Program.
The provider's business location address is:
1145 W HEDGES AVE
SUITE B
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 5/25/2007 and was last updated on 8/22/2020.