Golden State Therapy Center
NPI #1720085343 in Lodi, California
Provider Information
- NPI Number
- 1720085343
- Entity Type
- Organization
- Organization Name
- Golden State Therapy Center
- Primary Specialty
- Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
- Enumeration Date
- Jun 29, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1235 W VINE ST
- Address 2
- SUITE 22
- City
- Lodi
- State
- California
- ZIP Code
- 95240-5109
- Phone
- (209) 369-6996
Authorized Official
- Name
- MR. FRANK LYMAN RUSSELL, MA, MFT
- Title
- ADMINISTRATOR
- Phone
- (209) 369-6996
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) — Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
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