Healthcare Provider Details

I. General information

NPI: 1427423904
Provider Name (Legal Business Name): FRESNO COUNTY, DEPARTMENT OF BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 E PLYMOUTH WAY
FRESNO CA
93720
US

IV. Provider business mailing address

2645 E PLYMOUTH WAY
FRESNO CA
93720-5460
US

V. Phone/Fax

Practice location:
  • Phone: 209-261-2930
  • Fax:
Mailing address:
  • Phone: 209-261-2930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FRESNO COUNTY DEPARTMENT
Title or Position: OF BEHAVIORAL HEALTH
Credential:
Phone: 559-600-9180