Provider Demographics
NPI:1952502676
Name:STANISLAUS COUNTY
Entity Type:Organization
Organization Name:STANISLAUS COUNTY
Other - Org Name:STANISLAUS COUNTY SUBSTANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BEHAVIORAL HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MFT
Authorized Official - Phone:209-525-6225
Mailing Address - Street 1:800 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-6131
Mailing Address - Country:US
Mailing Address - Phone:209-558-4752
Mailing Address - Fax:
Practice Address - Street 1:1501 F ST
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-2522
Practice Address - Country:US
Practice Address - Phone:209-558-4752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5016Medicaid