Healthcare Provider Details

I. General information

NPI: 1356264964
Provider Name (Legal Business Name): XENCARE IV, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 N MERIDIAN AVE
FRESNO CA
93710-4632
US

IV. Provider business mailing address

7084 N MAPLE AVE STE 101
FRESNO CA
93720-0393
US

V. Phone/Fax

Practice location:
  • Phone: 559-434-1839
  • Fax:
Mailing address:
  • Phone: 559-434-1839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: GEORGE KUTNERIAN
Title or Position: MANAGER
Credential:
Phone: 559-301-1393