County of Stanislaus

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COUNTY OF STANISLAUS

Practice address

800 Scenic Dr
Modesto, CA 95350-6131

Phone

(209) 525-6225

NPI assigned

May 30, 2007

Last updated

Feb 24, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

COUNTY OF STANISLAUSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ruben Imperial, MBA

Title

Behavioral Health Interim Director

Phone

(209) 525-6225

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GENESIS METHADONE Other name

Part of

Stan Co Mentalhealth SV

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1043411762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF STANISLAUS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF STANISLAUS",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "IMPERIAL",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH INTERIM DIRECTOR",
        "authorized_official_telephone_number": "209-525-6225",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5014",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GENESIS METHADONE",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GENESIS METHADONE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Manuel Cotta Jr., PT
• Cassidy Coulter
• County of Stanislaus
• County of Stanislaus
• County of Stanislaus
• County of Stanislaus (Reintegration Support Team)
• County of Stanislaus
• County of Stanislaus (Stanislaus County Health Services Agency McHenry Medical Office)
• County of Stanislaus (Collaborative Court Behavioral Health Services Team)
• County of Stanislaus

• Community/Behavioral Health Agency in Modesto, CA
• Providers in Modesto, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.