Provider Demographics
NPI:1316295876
Name:CRESTWOOD CENTER BEHAVIORAL HEALTH INC
Entity type:Organization
Organization Name:CRESTWOOD CENTER BEHAVIORAL HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SERVICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:SHANTE
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-520-2785
Mailing Address - Street 1:2600 STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2210
Mailing Address - Country:US
Mailing Address - Phone:916-520-2785
Mailing Address - Fax:916-452-1093
Practice Address - Street 1:2600 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2210
Practice Address - Country:US
Practice Address - Phone:916-520-2785
Practice Address - Fax:916-452-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital