Healthcare Provider Details

I. General information

NPI: 1386996783
Provider Name (Legal Business Name): RAINTREE CONVALESCENT HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5265 E HUNTINGTON AVE
FRESNO CA
93727-4013
US

IV. Provider business mailing address

5265 E HUNTINGTON AVE
FRESNO CA
93727-4013
US

V. Phone/Fax

Practice location:
  • Phone: 559-251-8245
  • Fax: 559-251-5138
Mailing address:
  • Phone: 559-251-8245
  • Fax: 559-251-5138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: GARY L WILLIAMS JR.
Title or Position: PRESIDENT
Credential:
Phone: 559-251-8245