Healthcare Provider Details

I. General information

NPI: 1528407137
Provider Name (Legal Business Name): DUNAMIS INC GROUP HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2822 E FLORADORA AVE
FRESNO CA
93703-3906
US

IV. Provider business mailing address

823 W SUSSEX WAY
FRESNO CA
93705-2021
US

V. Phone/Fax

Practice location:
  • Phone: 281-782-5887
  • Fax: 559-981-5039
Mailing address:
  • Phone: 281-782-5887
  • Fax: 559-981-5039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1000086AN
License Number StateCA

VIII. Authorized Official

Name: MR. ORLANDO GILLAM II
Title or Position: CEO
Credential:
Phone: 281-782-5887