Healthcare Provider Details

I. General information

NPI: 1326064429
Provider Name (Legal Business Name): CASTLE FAMILY HEALTH CENTER & ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 HOSPITAL RD SUITE H
ATWATER CA
95301-5173
US

IV. Provider business mailing address

3605 HOSPITAL RD SUITE H
ATWATER CA
95301-5173
US

V. Phone/Fax

Practice location:
  • Phone: 209-381-2000
  • Fax: 209-726-0278
Mailing address:
  • Phone: 209-381-2000
  • Fax: 209-726-0278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS DEBBIE MARIE KELLEY
Title or Position: DIRECTOR OF BUSINESS SERVICES
Credential:
Phone: 209-381-2000