MEDICARE: ADDICTION CENTERS OF EXCELLENCE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	163W00000X	Registered Nurse
3	207P00000X	Emergency Medicine Physician
4	207Q00000X	Family Medicine Physician
5	207R00000X	Internal Medicine Physician
6	207V00000X	Obstetrics & Gynecology Physician
7	208000000X	Pediatrics Physician
8	2084P0800X	Psychiatry Physician
9	208M00000X	Hospitalist Physician
10	251K00000X	Public Health or Welfare Agency
11	251S00000X	Community/Behavioral Health Agency
12	261QM1300X	Multi-Specialty Clinic/Center
13	261QR1300X	Rural Health Clinic/Center
14	363L00000X	Nurse Practitioner
15	261QP0905X	State or Local Public Health Clinic/Center

General Provider Information

NPI Number	:	1518644608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDICTION CENTERS OF EXCELLENCE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 579702
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95357-9702
Country	:	US
Telephone Number	:	877-223-7669
Fax Number	:

Provider Business Practice Location Address
First Line	:	3812 SUNDANCE LAKE CT
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95355-7309
Country	:	US
Telephone Number	:	877-223-7669
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KASEY NICOLE HANDWERKER
Credential	:
Telephone Number	:	850-530-7070

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	01/10/2025

Similar Medicare Providers

1689314726 — UROOJ ZAHID
Practice Location Address:

600 COFFEE RD
MODESTO, CA
95355-4201

Practice Phone: 209-550-4755
Practice Fax:

1033512868 — MARIETTA BERMUDEZ GUAJARDO FNP-BC
Practice Location Address:

600 COFFEE RD
MODESTO, CA
95355-4201

Practice Phone: 209-524-1211
Practice Fax: 209-550-4830

1982226791 — MARISSA SUE BUENDIA DO
Practice Location Address:

1401 SPANOS CT STE 230
MODESTO, CA
95355-2816

Practice Phone: 209-550-4720
Practice Fax: 209-572-2923

1649281569 — DEITRICK LEELLEN GORMAN DO
Practice Location Address:

600 COFFEE RD
MODESTO, CA
95355-4201

Practice Phone: 209-550-4755
Practice Fax: 510-491-7522

1023399557 — MALARKODI GUNASEKARAN NP
Practice Location Address:

600 COFFEE RD
MODESTO, CA
95355-4201

Practice Phone: 209-550-4755
Practice Fax: 510-491-7522

1427989474 — DR. JORDAN BARNES PHARMD
Practice Location Address:

1700 COFFEE RD
MODESTO, CA
95355-2803

Practice Phone: 209-526-4500
Practice Fax:

Directions to “ADDICTION CENTERS OF EXCELLENCE, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.