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General NPI Number Information
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NPI Number | 1447758024
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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 | 01/29/2018
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 450 STANYAN ST FL 5
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-1019
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Country | US
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Telephone | 209-955-2328
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Fax | 209-644-5721
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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 | 209-644-5721
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR REIMBURSEMENT
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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 | 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 | CA
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