Healthcare Provider Details

I. General information

NPI: 1659244853
Provider Name (Legal Business Name): CENTERS FOR LIVING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4417 E INYO ST
FRESNO CA
93702-2977
US

IV. Provider business mailing address

355 E GETTYSBURG
FRESNO CALIFORNIA
93704
US

V. Phone/Fax

Practice location:
  • Phone: 559-708-7704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KEEGAN DAVIS
Title or Position: CHIEF STRATEGY OFFICER
Credential: SUDCC-III, APSYD
Phone: 559-708-7704