Healthcare Provider Details

I. General information

NPI: 1912916198
Provider Name (Legal Business Name): ALZHEIMER'S LIVING CENTER AT ELIM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

668 E BULLARD AVE
FRESNO CA
93710-5401
US

IV. Provider business mailing address

6276 N 1ST ST SUITE 103B
FRESNO CA
93710-5400
US

V. Phone/Fax

Practice location:
  • Phone: 559-320-2281
  • Fax: 559-320-2292
Mailing address:
  • Phone: 559-438-1858
  • Fax: 559-261-1065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. R. E. HOWE
Title or Position: PRESIDENT
Credential:
Phone: 559-438-1858