Healthcare Provider Details

I. General information

NPI: 1477626422
Provider Name (Legal Business Name): COUNTY OF TULARE HEALTH AND HUMAN SERVICES AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N LOVERS LN
VISALIA CA
93292-3102
US

IV. Provider business mailing address

5957 S MOONEY BLVD
VISALIA CA
93277-9394
US

V. Phone/Fax

Practice location:
  • Phone: 559-685-2533
  • Fax:
Mailing address:
  • Phone: 559-737-4669
  • Fax: 559-737-4697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License NumberNOT APPLICABLE
License Number State

VIII. Authorized Official

Name: RAYMOND BULLICK
Title or Position: DIRECTOR OF HEALTH SERVICES
Credential:
Phone: 559-737-4669