Healthcare Provider Details

I. General information

NPI: 1952438467
Provider Name (Legal Business Name): WESTCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E BELMONT AVE
FRESNO CA
93701-1502
US

IV. Provider business mailing address

315 E NEES AVE APT 137
FRESNO CA
93720-2014
US

V. Phone/Fax

Practice location:
  • Phone: 559-237-3420
  • Fax:
Mailing address:
  • Phone: 559-906-5549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. BRANDI LEE DUNCAN
Title or Position: INTAKE COUNSELOR
Credential:
Phone: 559-265-4800