Healthcare Provider Details

I. General information

NPI: 1215001763
Provider Name (Legal Business Name): PORTERVILLE CONVALESCENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W MORTON AVE
PORTERVILLE CA
93257-1947
US

IV. Provider business mailing address

1100 W MORTON AVE
PORTERVILLE CA
93257-1947
US

V. Phone/Fax

Practice location:
  • Phone: 559-782-1509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number120000621
License Number StateCA

VIII. Authorized Official

Name: JAMES HIGBEE
Title or Position: CFO
Credential:
Phone: 559-688-0288