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General NPI Number Information
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NPI Number | 1679383566
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Entity Type | Organization
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Legal Business Name | MINERALS BATHS COMMUNITY
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 323 W 7TH ST
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City | STOCKTON
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State | CA
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Zip | 95206-2501
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Country | US
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Telephone | 510-292-1337
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6951
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City | STOCKTON
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State | CA
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Zip | 95206-1061
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Country | US
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Telephone | 510-292-1337
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. PATRICIA BARRETT
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Credential |
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Telephone | 510-292-1337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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