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General NPI Number Information
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NPI Number | 1639592421
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Entity Type | Organization
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Legal Business Name | STANISLAUS COUNTY, DEPT OF AGING AND VETERANS SERVICES, MSSP
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Dates
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Enumeration Date | 01/29/2014
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Last Update Date | 01/29/2014
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Provider Practice Location Address
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Address Line | 121 DOWNEY AVE STE 102
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City | MODESTO
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State | CA
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Zip | 95354-1235
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Country | US
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Telephone | 209-525-4601
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Fax | 209-558-8152
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Provider Business Mailing Address
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Address Line | 121 DOWNEY AVE STE 102
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City | MODESTO
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State | CA
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Zip | 95354-1235
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Country | US
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Telephone | 209-525-4601
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Fax | 209-558-8152
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARGIE PALOMINO
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Credential |
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Telephone | 20952524601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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