Healthcare Provider Details

I. General information

NPI: 1366653883
Provider Name (Legal Business Name): CENTER FOR HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HACKETT RD
MODESTO CA
95358-9800
US

IV. Provider business mailing address

1700 MCHENRY VILLAGE WAY STE 11
MODESTO CA
95350-4308
US

V. Phone/Fax

Practice location:
  • Phone: 209-526-1476
  • Fax: 209-526-0908
Mailing address:
  • Phone: 209-526-1476
  • Fax: 209-526-0908

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: CINDY DUENAS
Title or Position: PROGRAM DIRECTOR
Credential: MFT
Phone: 209-526-1476