Healthcare Provider Details

I. General information

NPI: 1225117823
Provider Name (Legal Business Name): CLOVIS ADULT DAY HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W BULLARD AVE STE 113
CLOVIS CA
93612-0945
US

IV. Provider business mailing address

50 W BULLARD AVE STE 113
CLOVIS CA
93612-0945
US

V. Phone/Fax

Practice location:
  • Phone: 559-298-3996
  • Fax: 559-298-2074
Mailing address:
  • Phone: 559-298-3996
  • Fax: 559-298-2074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. KARL L. NOYES
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 559-298-3996