1457582264 NPI number — MCGREW BEHAVIOR INTERVENTION SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457582264 NPI number — MCGREW BEHAVIOR INTERVENTION SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCGREW BEHAVIOR INTERVENTION SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457582264
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
229 NEWBURY WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMERICAN CANYON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94503-4228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-246-7920
Provider Business Mailing Address Fax Number:
707-648-0393

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1133 COOMBSVILLE RD
Provider Second Line Business Practice Location Address:
SILVERADO MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
NAPA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94558-3906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-246-7920
Provider Business Practice Location Address Fax Number:
707-648-0393
Provider Enumeration Date:
07/29/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MCGREW
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATIVE CLINICIAN
Authorized Official Telephone Number:
707-246-7920

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MFC30275 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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