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General NPI Number Information
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NPI Number | 1235631391
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Entity Type | Organization
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Legal Business Name | EUREKA PROGRAMS LLC
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Dates
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Enumeration Date | 03/05/2018
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Last Update Date | 03/05/2018
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Provider Practice Location Address
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Address Line | 916 WATERMAN AVE
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City | FRESNO
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State | CA
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Zip | 93706-3762
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Country | US
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Telephone | 559-321-1309
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Fax |
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Provider Business Mailing Address
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Address Line | 2277 GOSHEN AVE
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City | CLOVIS
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State | CA
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Zip | 93611-8104
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Country | US
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Telephone | 559-321-1309
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VALETTE FARWELL
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Credential |
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Telephone | 559-321-1309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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