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NPI Code Detail

MEDICARE: COURAGE-U

MEDICARE: COURAGE-U
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1104681022
Entity Type Code : Organization
Provider Name (Legal Business Name) : COURAGE-U
Provider Business Mailing Address
First Line : 1960 N GATEWAY BLVD
Second Line :
City : FRESNO
State : CA
Zip : 93727-1604
Country : US
Telephone Number : 559-266-5200
Fax Number : 559-266-5201
Provider Business Practice Location Address
First Line : 1960 N GATEWAY BLVD
Second Line :
City : FRESNO
State : CA
Zip : 93727-1604
Country : US
Telephone Number : 559-266-5200
Fax Number : 559-266-5201
Authorized Official
Title or Position : EXECUTIVE CLINICAL DIRECTOR
Name : MOR XIONG POPPER
Credential : LCSW
Telephone Number : 559-266-5200
Provider Enumeration Date : 02/20/2024
Last Update Date : 02/20/2024

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Directions to “COURAGE-U ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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