Emotional and Behavioral Helath Services

Organization Active NPI Clinic/Center · Copperopolis, CA

NPI 1487986519 · NPPES record last updated Jan 29, 2010

Key facts

NPI
1487986519
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
License
12670 (CA)
Legal business name
EMOTIONAL AND BEHAVIORAL HELATH SERVICES
Practice address
1165 Ranch Rd
Copperopolis, CA 95228
Phone
(209) 785-7766
NPI assigned
Jan 29, 2010
Organization subpart
No

Authorized official

Name
Mr. John Tim Rourke, PHD
Title
Owner
Phone
(209) 785-7766

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 12670 CA Yes

Addresses

Primary practice location

1165 Ranch Rd
Copperopolis, CA 95228

Mailing address

PO Box 189
Copperopolis, CA 95228-0189
Phone (209) 785-7766

Other providers in Copperopolis, CA

All providers in Copperopolis, CA · Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.