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General NPI Number Information
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NPI Number | 1386919983
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Entity Type | Organization
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Legal Business Name | DEDICATED CARE IN-HOME SERVICES
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 3995 N FRESNO ST SUITE 108
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City | FRESNO
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State | CA
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Zip | 93726-4031
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Country | US
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Telephone | 559-765-0888
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Fax | 559-761-1037
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Provider Business Mailing Address
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Address Line | 3995 N FRESNO ST SUITE 108
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City | FRESNO
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State | CA
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Zip | 93726-4031
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Country | US
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Telephone | 559-765-0888
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Fax | 559-761-1037
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ANTONIO R CHAVEZ
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Credential |
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Telephone | 559-765-0888
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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 | 102067004961294
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License Number State | CA
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