Healthcare Provider Details

I. General information

NPI: 1497939441
Provider Name (Legal Business Name): WESTCARE CALIFORNIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 W. WHITESBRIDGE ROAD
FRESNO CA
93706
US

IV. Provider business mailing address

4944 E CLINTON WAY STE 101
FRESNO CA
93727-1527
US

V. Phone/Fax

Practice location:
  • Phone: 559-268-4800
  • Fax: 559-268-0738
Mailing address:
  • Phone: 559-251-4800
  • Fax: 559-453-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number100010JN
License Number StateCA

VIII. Authorized Official

Name: MR. MAURICE LEE
Title or Position: REGIONAL VICE PRESIDENT
Credential:
Phone: 559-251-4800