| Organization Name: | STATE HEALTH CARE DUAL DIAGNOSIS |
| NPI Number: | 1043265044 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDNA ELIZABETH MILLER (PRESIDENT) |
| Mailing Address: | 4042 S Demaree St Visalia |
| State: | CA US |
| Postal Code: | 932779476 |
| Phone Number: | 3106289512 |
| Fax Number: | 8183925025 |
| NPI Enumeration Date: | 05/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |