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General NPI Number Information
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NPI Number | 1639852387
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Entity Type | Organization
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Legal Business Name | S&G BEHAVIORAL HEALTH SERVICES INC.
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Dates
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Enumeration Date | 08/09/2023
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 3445 WINTON PL STE 109
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City | ROCHESTER
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State | NY
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Zip | 14623-2950
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Country | US
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Telephone | 307-761-4249
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Fax |
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Provider Business Mailing Address
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Address Line | 2167 SHAW AVE STE 115
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City | CLOVIS
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State | CA
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Zip | 93611-8935
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Country | US
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Telephone | 307-761-4249
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS JACQUELINE GREGORY
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Credential | PHD, FNP-C PMHNP-BC
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Telephone | 307-761-4249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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