Healthcare Provider Details

I. General information

NPI: 1629739917
Provider Name (Legal Business Name): VALLEY CAREGIVER RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5377 N FRESNO ST STE 101
FRESNO CA
93710-6875
US

IV. Provider business mailing address

5363 N FRESNO ST
FRESNO CA
93710-6848
US

V. Phone/Fax

Practice location:
  • Phone: 559-224-9154
  • Fax:
Mailing address:
  • Phone: 559-224-9154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE C EAVES
Title or Position: ACCOUNTING & BUDGET MANAGER
Credential: DO
Phone: 559-224-9154