Healthcare Provider Details

I. General information

NPI: 1780379214
Provider Name (Legal Business Name): FRESNO RESCUE MISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E DAKOTA AVE
FRESNO CA
93726-4804
US

IV. Provider business mailing address

2025 E DAKOTA AVE
FRESNO CA
93726-4804
US

V. Phone/Fax

Practice location:
  • Phone: 559-268-0839
  • Fax:
Mailing address:
  • Phone: 559-268-0839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PRISCILLA ROBBINS
Title or Position: CHIEF MINISTRY OFFICER
Credential:
Phone: 559-268-0839