ADOLESCENCE'S LAST RESORT
Hospitals at Mchenry Ave, Modesto, CA

License number
California 50010AN
Category
Hospitals
Type
Rehabilitation, Substance Use Disorder Unit
Owner
Name: MICHELLE DENISE LUCAS
Title: ADMINISTRATOR
Phone: (209) 523-6900
Address
Address
3125 Mchenry Ave SUITE D, Modesto, CA 95350
National Provider ID: 1841585015
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ADOLESCENCE'S LAST RESORT

Modesto, CA

Industry:
Hotel/Motel Operation
Registration:
Feb 10, 2010
Addresses:
3125 Mchenry Ave STE D, Modesto, CA 95350 (Physical)
400 12 St, Modesto, CA 95354
PO Box 3973, Modesto, CA 95352
State ID:
C3278103
Business type:
Articles of Incorporation
Presidents:
Mary Jane Terry (President),Melissa Lynn Muncrief President, inactive
Agent:
Melissa Muncrief,Modesto, CA 95350 (Physical)

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