Healthcare Provider Details
I. General information
NPI: 1770197659
Provider Name (Legal Business Name): THE FRESNO CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/08/2020
Last Update Date: 08/23/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4855 E CESAR CHAVEZ BLVD
FRESNO CA
93727-3811
US
IV. Provider business mailing address
1725 N FINE AVE
FRESNO CA
93727-1616
US
V. Phone/Fax
- Phone: 559-255-8395
- Fax: 559-255-1656
- Phone: 559-255-8395
- Fax: 559-255-1656
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENSEN
VANG
Title or Position: CFO/CHIEF DEVELOPMENT OFFICER
Credential:
Phone: 559-255-8395