Healthcare Provider Details
I. General information
NPI: 1306413471
Provider Name (Legal Business Name): XENCARE II, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2021
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2099 E BURLINGAME AVE
FRESNO CA
93710-4501
US
IV. Provider business mailing address
PO BOX 27156
FRESNO CA
93729-7156
US
V. Phone/Fax
- Phone: 559-301-1393
- Fax: 559-797-4494
- Phone: 559-301-1393
- Fax: 559-797-4494
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEORGE
KUTNERIAN
Title or Position: PRESIDENT
Credential:
Phone: 559-301-1393