Healthcare Provider Details
I. General information
NPI: 1720769474
Provider Name (Legal Business Name): STAY FOCUSED MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2023
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1225 CALIFORNIA AVE
BAKERSFIELD CA
93304-1403
US
IV. Provider business mailing address
1225 CALIFORNIA AVE
BAKERSFIELD CA
93304-1403
US
V. Phone/Fax
- Phone: 661-322-4673
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251X00000X |
| Taxonomy | Supports Brokerage Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MANUEL
CARRIZALEZ
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 661-322-4673