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1467897751
MARIO VINCENTE BENAVIDEZ
MODESTO, CA
NPI
1467897751
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA C032690315)
Enumeration Date
2013-05-01
Last Update Date
2024-07-24
Business Address
MARIO VINCENTE BENAVIDEZ CADC-CAS
190 E HACKETT RD
MODESTO, CA 95358-9001
Phone number: 209-525-7218
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Mailing Address
MARIO VINCENTE BENAVIDEZ CADC-CAS
800 SCENIC DR BLDG 4
MODESTO, CA 95350-6131
Phone number: 209-525-6146
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