Healthcare Provider Details

I. General information

NPI: 1700600848
Provider Name (Legal Business Name): XENCARE III, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 E MAGILL AVE
FRESNO CA
93710-4817
US

IV. Provider business mailing address

PO BOX 27156
FRESNO CA
93729-7156
US

V. Phone/Fax

Practice location:
  • Phone: 559-301-1393
  • Fax: 559-797-4494
Mailing address:
  • Phone: 559-301-1393
  • Fax: 559-797-4494

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: MR. GEORGE KUTERIAN
Title or Position: PRESIDENT
Credential:
Phone: 559-301-1393