Healthcare Provider Details

I. General information

NPI: 1235979915
Provider Name (Legal Business Name): MARIAN HOMES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3086 ARMSTRONG AVE
CLOVIS CA
93611-5201
US

IV. Provider business mailing address

3086 ARMSTRONG AVE
CLOVIS CA
93611-5201
US

V. Phone/Fax

Practice location:
  • Phone: 559-347-9900
  • Fax: 559-347-0706
Mailing address:
  • Phone: 559-347-9900
  • Fax: 559-347-0706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: SUNDARI SUSAN KENDAKUR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 559-347-9900