Healthcare Provider Details

I. General information

NPI: 1972433779
Provider Name (Legal Business Name): PARENT RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 5TH ST
MODESTO CA
95351-2808
US

IV. Provider business mailing address

811 5TH ST
MODESTO CA
95351-2808
US

V. Phone/Fax

Practice location:
  • Phone: 209-549-8193
  • Fax: 209-576-8718
Mailing address:
  • Phone: 209-549-8193
  • Fax: 209-576-8718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: SUSAN BEASLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 209-549-8193