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General NPI Number Information
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NPI Number | 1194145144
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Entity Type | Organization
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Legal Business Name | GARDENIA SENIOR CARE CENTER INC
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Dates
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Enumeration Date | 04/17/2014
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Last Update Date | 04/17/2014
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Provider Practice Location Address
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Address Line | 2939 S PEACH AVE
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City | FRESNO
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State | CA
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Zip | 93725-9302
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Country | US
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Telephone | 510-604-0348
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Fax | 510-763-7367
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Provider Business Mailing Address
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Address Line | 2939 S PEACH AVE
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City | FRESNO
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State | CA
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Zip | 93725-9302
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Country | US
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Telephone | 510-604-0348
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Fax | 510-763-7367
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS NOORJAHAN SYED
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Credential |
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Telephone | 510-604-0348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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