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General NPI Number Information
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NPI Number | 1235281304
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Entity Type | Organization
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Legal Business Name | ALLEN-SPEES FAMILY HOME III
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 286 W SIERRA AVE
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City | FRESNO
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State | CA
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Zip | 93704-1228
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Country | US
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Telephone | 559-432-6798
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Fax | 559-449-0859
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Provider Business Mailing Address
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Address Line | 286 W SIERRA AVE
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City | FRESNO
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State | CA
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Zip | 93704-1228
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Country | US
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Telephone | 559-432-6798
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Fax | 559-449-0859
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Authorized Official
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Title or Position | OWNER LICENSEE
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Name | SUE ALLEN
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Credential |
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Telephone | 559-432-6798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | CA
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