Healthcare Provider Details

I. General information

NPI: 1811873250
Provider Name (Legal Business Name): LUMITHRIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 E BARSTOW AVE
FRESNO CA
93710-5003
US

IV. Provider business mailing address

191 E BARSTOW AVE
FRESNO CA
93710-5003
US

V. Phone/Fax

Practice location:
  • Phone: 559-478-3736
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PA VUE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: RN
Phone: 559-478-3736