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General NPI Number Information
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NPI Number | 1053187914
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Entity Type | Organization
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Legal Business Name | CRESTWOOD BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 520 CAPITOL MALL STE 800
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City | SACRAMENTO
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State | CA
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Zip | 95814-4716
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Country | US
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Telephone | 916-471-2244
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7095
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City | STOCKTON
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State | CA
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Zip | 95267-0095
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Country | US
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Telephone | 209-955-2339
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR AR & REIMB.
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Name | MICHELLE SMITH
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Credential |
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Telephone | 209-955-2364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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Taxonomy #4
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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Taxonomy #5
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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