Healthcare Provider Details

I. General information

NPI: 1730775990
Provider Name (Legal Business Name): PORTERVILLE ADULT DAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 N 2ND ST
PORTERVILLE CA
93257-3845
US

IV. Provider business mailing address

262 N 2ND ST
PORTERVILLE CA
93257-3845
US

V. Phone/Fax

Practice location:
  • Phone: 559-793-7955
  • Fax: 559-560-9013
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNIE ZAKARYAN
Title or Position: CEO
Credential:
Phone: 323-395-7540