1538485461 NPI number — CENTRAL VALLEY CARE, 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 1538485461 NPI number — CENTRAL VALLEY CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL VALLEY CARE, 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:
COMFORT KEEPERS
Provider Other Organization Name Type Code:
3
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:
1538485461
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1849 N HELM AVE
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93727-1624
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-456-8064
Provider Business Mailing Address Fax Number:
559-456-8077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1849 N HELM AVE
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93727-1624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-456-8064
Provider Business Practice Location Address Fax Number:
559-456-8077
Provider Enumeration Date:
04/16/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HATCH
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
ELAINE
Authorized Official Title or Position:
SECRETRAY/GENERAL MANAGER
Authorized Official Telephone Number:
559-456-8064

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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