Healthcare Provider Details

I. General information

NPI: 1851560916
Provider Name (Legal Business Name): LAVANG CARE HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4644 N BARCUS AVE
FRESNO CA
93722-8656
US

IV. Provider business mailing address

2557 E GOSHEN AVE
FRESNO CA
93720-0503
US

V. Phone/Fax

Practice location:
  • Phone: 559-515-6823
  • Fax: 800-496-0381
Mailing address:
  • Phone: 559-578-6624
  • Fax: 800-496-0381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: ARLENE PALLANAN BAUTISTA
Title or Position: DON
Credential: BSN, RN
Phone: 559-704-6796