Healthcare Provider Details

I. General information

NPI: 1205781069
Provider Name (Legal Business Name): COSTI INDUSTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 W SCOTT AVE
FRESNO CA
93711-3006
US

IV. Provider business mailing address

702 BLOSSOM WAY S
MADERA CA
93636-8949
US

V. Phone/Fax

Practice location:
  • Phone: 559-944-1913
  • Fax:
Mailing address:
  • Phone: 559-944-1913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY BRANDON COSTI
Title or Position: CEO/ADMINISTRATOR
Credential: RCFE ADMINISTRATOR
Phone: 559-944-1913