Modesto Residential Living Center in Modesto - Community Based Residential Treatment Facility, Mental Illness
Modesto Residential Living Center - NPI 1720207418
Modesto Residential Living Center is a Community Based Residential Treatment Facility, Mental Illness in Modesto, California. Modesto Residential Living Center practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Modesto Residential Living Center is 1720207418. The last update date is 2020-08-22.
Modesto Residential Living Center's current location address is 1932 Evergreen Ave, Modesto, California. You can contact this provider via phone number 2095309300 and fax number 2095309303. The mailing address for Modesto Residential Living Center is 1932 Evergreen Ave, Modesto, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Modesto Residential Living Center |
|---|---|
| Address | 1932 Evergreen Ave, Modesto, California |
| Phone Number | 2095309300 |
| Fax Number | 2095309303 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Monterosso A Dennis |
| Telephone Number | 2095309300 |
NPI Number Detail
| NPI Number | 1720207418 |
|---|---|
| Provider Enumeration Date | 2007-04-24 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1932 Evergreen Ave |
|---|---|
| City | Modesto |
| State | California (CA) |
| Post Code | 953503738 |
| Phone Number | 2095309300 |
| Fax Number | 2095309303 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
|
Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
|
Post Comment/ Review Below
What is the unique identifier code issued to Modesto Residential Living Center by the Centers for Medicare & Medicaid Services (CMS)?
The Modesto Residential Living Center has been assigned the NPI (National Provider Identifier) 1720207418. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Modesto Residential Living Center located?
The Modesto Residential Living Center is located at 1932 Evergreen Ave, Modesto, CA 953503738.
What is Modesto Residential Living Center's area of expertise and its corresponding taxonomy classification?
The Modesto Residential Living Center's field of specialization is Community Based Residential Treatment Facility, Mental Illness, and it falls under the taxonomy code 320800000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1720207418 to Modesto Residential Living Center?
The Centers for Medicare & Medicaid Services originally issued the 1720207418 to Modesto Residential Living Center on 2007-04-24.
When was the Modesto Residential Living Center's information last updated?
The Modesto Residential Living Center's information was last updated on 2020-08-22.
NPI Number: 1457354839
Address: P.o. Box 1252, Spartanburg, SC