institution
State Health Care Dual Diagnosis Program
Substance Use Disorder Rehabilitation Clinic/Center in Fresno, California
NPI 1720299175

State Health Care Dual Diagnosis Program is a Substance Use Disorder Rehabilitation Clinic/Center based in Northridge, CA and is specialized in Rehabilitation, Substance Use Disorder. State Health Care Dual Diagnosis Program practices in Fresno, CA. The NPI Number for State Health Care Dual Diagnosis Program is 1720299175 and holds a License No. 100056BP (California).

The current practice location address for State Health Care Dual Diagnosis Program is 1145 W Hedges Ave, Fresno, CA and can be reached out via phone at 310-628-9512 and via fax at 818-804-4047.

Location: 1145 W Hedges Ave, Fresno, CA, 91326-1651
institution
Provider Profile Details
NPI Number
1720299175
Provider Name
State Health Care Dual Diagnosis Program
Credential
Provider Entity Type
Organization
Address
1145 W Hedges Ave, Fresno, CA, 91326-1651
Phone Number
310-628-9512
Fax Number
818-804-4047
Provider Enumeration Date
05/25/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1068 01 CA DMC PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
1145 W Hedges Ave
City
State
Zip
93728-1219
Phone Number
310-628-9512
Fax Number
818-804-4047
person
Provider Business Mailing Address Details
Address
1145 W Hedges Ave
City
State
Zip
93728-1219
Phone Number
310-628-9512
Fax Number
818-804-4047
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
License No.
100056BP (California)
Definition
Definition to come...
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