<Unavail>

LBN: State Health Care Dual Diagnosis Program
<Unavail> is an health care organization with primary practice located at 1145 W Hedges Ave Suite B, Fresno CA 93728-1219. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, which is considered as the primary health care specialty. State Health Care Dual Diagnosis Program can be contacted via phone (310) 628-9512, or through Miller, Edna via phone (310) 628-9512.

Contact Information

Primary practice address
1145 W Hedges Ave Suite B Fresno CA 93728-1219
Phone: (310) 628-9512
Fax: (818) 804-4047
Website:
Map and Directions
Authorized official contact:
Name: Miller, Edna
Phone: (310) 628-9512

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 100056BP California

Profile Details

NPI number 1720299175
LBN Legal business name State Health Care Dual Diagnosis Program
DBA Doing business as <Unavail>
Authorized official Miller, Edna
Entity Organization
Organization subpart 1 No
Enumeration date May 25th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720299175 NPPES
California Other 1068 DMC PROVIDER NUMBER

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