Healthcare Provider Details

I. General information

NPI: 1912274440
Provider Name (Legal Business Name): EMINENCE HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2011
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7170 N FINANCIAL DR SUITE 135
FRESNO CA
93720-2939
US

IV. Provider business mailing address

7170 N FINANCIAL DR SUITE 135
FRESNO CA
93720-2939
US

V. Phone/Fax

Practice location:
  • Phone: 559-221-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DONNIE ANDRADE
Title or Position: CEO
Credential:
Phone: 559-221-8100