Provider Demographics
NPI:1679383566
Name:MINERALS BATHS COMMUNITY
Entity type:Organization
Organization Name:MINERALS BATHS COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-292-1337
Mailing Address - Street 1:PO BOX 6951
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-1061
Mailing Address - Country:US
Mailing Address - Phone:510-292-1337
Mailing Address - Fax:
Practice Address - Street 1:323 W 7TH ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-2501
Practice Address - Country:US
Practice Address - Phone:510-292-1337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)