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NPI 1265501597

NPI 1265501597 : CRESTWOOD BEHAVIORAL HEALTH, INC. : BAKERSFIELD, CA

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General NPI Number Information
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    NPI Number           |    1265501597
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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     |    11/08/2006
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    Last Update Date     |    09/16/2025
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Provider Practice Location Address
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    Address Line         |    6744 EUCALYPTUS DR 
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    City                 |    BAKERSFIELD
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    State                |    CA
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    Zip                  |    93306-6053
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    Country              |    US
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    Telephone            |    661-363-6711
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    Fax                  |    661-363-9124
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Provider Business Mailing Address
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    Address Line         |    7590 SHORELINE DR 
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    City                 |    STOCKTON
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    State                |    CA
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    Zip                  |    95219-5455
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    Country              |    US
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    Telephone            |    209-955-2328
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    Fax                  |    209-952-5314
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Authorized Official
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    Title or Position    |    EXECUTIVE DIRECTOR REIMBURSEMENT
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    Name                 |    MRS. MICHELLE  SMITH 
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    Credential           |    
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    Telephone            |    209-955-2316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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