Provider Demographics
NPI:1194858076
Name:CENTER FOR HUMAN SERVICES
Entity type:Organization
Organization Name:CENTER FOR HUMAN SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-526-1476
Mailing Address - Street 1:2000 W. BRIGGSMORE AVENUE
Mailing Address - Street 2:STE. I
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4308
Mailing Address - Country:US
Mailing Address - Phone:209-526-1476
Mailing Address - Fax:209-526-0908
Practice Address - Street 1:1010 W LAS PALMAS AVE STE E
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363-8873
Practice Address - Country:US
Practice Address - Phone:209-690-3100
Practice Address - Fax:209-892-6949
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50A9Medicaid