Healthcare Provider Details

I. General information

NPI: 1538277801
Provider Name (Legal Business Name): VALLEY HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4840 E TULARE AVE
FRESNO CA
93727-3062
US

IV. Provider business mailing address

4840 E TULARE AVE
FRESNO CA
93727-3062
US

V. Phone/Fax

Practice location:
  • Phone: 559-251-7161
  • Fax:
Mailing address:
  • Phone: 559-251-7161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number040000161
License Number StateCA

VIII. Authorized Official

Name: MRS. ANDREA ABBES
Title or Position: ADMINISTRATOR
Credential:
Phone: 559-251-7161