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General NPI Number Information
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NPI Number | 1417437047
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Entity Type | Organization
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Legal Business Name | HERGIE & ASSOCIATES
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Dates
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Enumeration Date | 08/14/2018
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 1760 E CHENNAULT AVE
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City | FRESNO
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State | CA
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Zip | 93720-3812
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Country | US
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Telephone | 559-297-7530
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Fax | 559-324-0729
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Provider Business Mailing Address
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Address Line | 2145 BEDFORD AVE
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City | CLOVIS
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State | CA
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Zip | 93611-8118
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Country | US
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Telephone | 559-297-7530
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Fax | 559-324-0729
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. JULIE RENEE HERGENROEDER
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Credential |
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Telephone | 559-259-2283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 107201085
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License Number State | CA
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