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General NPI Number Information
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NPI Number | 1477402394
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Entity Type | Organization
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Legal Business Name | CORCO ENTERPRISES, LLC
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 13565 GRANGEVILLE BLVD
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City | HANFORD
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State | CA
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Zip | 93230-9465
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Country | US
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Telephone | 559-670-3076
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Fax | 559-670-3094
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Provider Business Mailing Address
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Address Line | 240 N 12TH AVE STE 109 PMB 324
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City | HANFORD
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State | CA
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Zip | 93230-9465
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Country | US
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Telephone | 559-670-3076
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Fax | 559-670-3094
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Authorized Official
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Title or Position | CEO
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Name | CORY ANDERSEN
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Credential |
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Telephone | 559-977-6801
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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 |
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License Number State |
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