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General NPI Number Information
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NPI Number | 1427355536
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Entity Type | Organization
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Legal Business Name | PORTERVILLE HALFWAY HOUSE
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 184 W BELLEVIEW AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-2257
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Country | US
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Telephone | 559-781-0107
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Fax | 559-781-7521
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Provider Business Mailing Address
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Address Line | 184 W BELLEVIEW AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-2257
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Country | US
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Telephone | 559-781-0107
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Fax | 559-781-7521
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CLARK E. MURRAY
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Credential |
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Telephone | 559-781-0107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 540001HN
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License Number State | CA
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