Modesto Adult Day Program Partners

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

502700147 Issued in CA

Legal business name

MODESTO ADULT DAY PROGRAM PARTNERS

Practice address

3217 Tully Rd
Modesto, CA 95350-0832

Phone

(209) 622-0963

Fax

(209) 661-4903

NPI assigned

Mar 21, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Russell N Milnes

Title

General Partner/Administrator

Phone

(209) 622-0963

Specialties & licenses 1

Addresses

Other names 1

• Modesto Adult Day Program Doing business as

Locations

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1669903852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 TULLY RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500832",
            "telephone_number": "209-622-0963",
            "fax_number": "209-661-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 TULLY RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500832",
            "telephone_number": "209-622-0963",
            "fax_number": "209-661-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODESTO ADULT DAY PROGRAM PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "MILNES",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "GENERAL PARTNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "209-622-0963",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "CA",
            "license": "502700147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modesto Adult Day Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Day Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.