Healthcare Provider Details

I. General information

NPI: 1174142798
Provider Name (Legal Business Name): ARIA COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SKYLINE BLVD STE C
AVENAL CA
93204-1850
US

IV. Provider business mailing address

PO BOX 580
LEMOORE CA
93245-0580
US

V. Phone/Fax

Practice location:
  • Phone: 559-386-4500
  • Fax: 559-386-0550
Mailing address:
  • Phone: 559-386-4500
  • Fax: 559-282-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: JOHN BLAINE
Title or Position: CEO
Credential:
Phone: 559-925-8800