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General NPI Number Information
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NPI Number | 1487031472
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Entity Type | Organization
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Legal Business Name | CRESTWOOD BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 4411 E KINGS CANYON RD
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City | FRESNO
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State | CA
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Zip | 93702-3604
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Country | US
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Telephone | 559-600-7177
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Fax | 559-600-7737
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Provider Business Mailing Address
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Address Line | 4411 E KINGS CANYON RD
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City | FRESNO
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State | CA
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Zip | 93702-3604
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Country | US
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Telephone | 559-600-7177
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Fax | 559-600-7737
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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 | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 700143
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License Number State | CA
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