Healthcare Provider Details

I. General information

NPI: 1336287077
Provider Name (Legal Business Name): MANNING GARDENS CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 10/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 E MANNING AVE
FRESNO CA
93725-9681
US

IV. Provider business mailing address

2113 E MANNING AVE
FRESNO CA
93725-9681
US

V. Phone/Fax

Practice location:
  • Phone: 559-834-2586
  • Fax: 559-834-2540
Mailing address:
  • Phone: 559-834-2586
  • Fax: 559-834-2540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number040000119
License Number StateCA

VIII. Authorized Official

Name: RONALD KINNERSLEY
Title or Position: PRESIDENT
Credential:
Phone: 559-972-7292