Healthcare Provider Details

I. General information

NPI: 1871674358
Provider Name (Legal Business Name): KAWEAH MANOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 W TULARE AVE
VISALIA CA
93277-1732
US

IV. Provider business mailing address

3710 W TULARE AVE
VISALIA CA
93277-1732
US

V. Phone/Fax

Practice location:
  • Phone: 559-732-2244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number120000588
License Number StateCA

VIII. Authorized Official

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