Provider Demographics
NPI:1427423904
Name:FRESNO COUNTY, DEPARTMENT OF BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:FRESNO COUNTY, DEPARTMENT OF BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OF BEHAVIORAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:FRESNO COUNTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPARTMENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-600-9180
Mailing Address - Street 1:2645 E PLYMOUTH WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-5460
Mailing Address - Country:US
Mailing Address - Phone:209-261-2930
Mailing Address - Fax:
Practice Address - Street 1:2645 E PLYMOUTH WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:209-261-2930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health