Healthcare Provider Details

I. General information

NPI: 1851893291
Provider Name (Legal Business Name): HERITAGE CROSSING FRESNO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2792 E ALLUVIAL AVE
CLOVIS CA
93611-9104
US

IV. Provider business mailing address

6311 N FRESNO ST STE 102
FRESNO CA
93710-5290
US

V. Phone/Fax

Practice location:
  • Phone: 559-288-9989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARI ZAKARYAN
Title or Position: PRESIDENT
Credential: RN
Phone: 559-297-0077