Healthcare Provider Details

I. General information

NPI: 1407761570
Provider Name (Legal Business Name): VILLAGE AT MILL CREEK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 E DOUGLAS AVE
VISALIA CA
93292-4008
US

IV. Provider business mailing address

2950 E DOUGLAS AVE
VISALIA CA
93292-4008
US

V. Phone/Fax

Practice location:
  • Phone: 559-625-6001
  • Fax:
Mailing address:
  • Phone: 559-625-6001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: JERRY SANADA
Title or Position: OWNER
Credential:
Phone: 805-300-5383