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General NPI Number Information
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NPI Number | 1265242440
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Entity Type | Organization
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Legal Business Name | FLORES RECREATED
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 5143 N VALENTINE AVE APT 102
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City | FRESNO
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State | CA
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Zip | 93711-2644
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Country | US
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Telephone | 559-776-1977
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | SANTA CRUZ
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State | CA
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Zip | 95061-0297
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MIGUEL FLORES
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Credential |
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Telephone | 559-473-7219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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