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General NPI Number Information
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NPI Number | 1083988463
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Entity Type | Organization
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Legal Business Name | BEL HAVEN CARE INC
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 2020 N WEBER AVE
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City | FRESNO
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State | CA
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Zip | 93705-4313
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Country | US
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Telephone | 559-486-5977
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Fax | 559-486-5909
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Provider Business Mailing Address
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Address Line | 69 LINCOLN BLVD # 239
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City | LINCOLN
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State | CA
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Zip | 95648-6303
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Country | US
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Telephone | 916-768-1128
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Fax | 916-585-9149
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SCOTT COURTNEY
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Credential |
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Telephone | 916-768-1128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 107202480
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 107202480
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License Number State | CA
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