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General NPI Number Information
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NPI Number | 1487193058
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Entity Type | Organization
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Legal Business Name | HASKINS RESIDENTIAL CARE
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 1037 S CHESTNUT AVE
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City | FRESNO
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State | CA
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Zip | 93702-3907
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Country | US
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Telephone | 559-453-6832
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Fax | 559-453-6959
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Provider Business Mailing Address
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Address Line | 1037 S CHESTNUT AVE
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City | FRESNO
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State | CA
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Zip | 93702-3907
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Country | US
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Telephone | 559-453-6832
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Fax | 559-453-6959
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Authorized Official
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Title or Position | DIRECTOR OF PROGRAMS AND OPERATIONS
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Name | NATALIE HASKINS
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Credential |
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Telephone | 559-453-6832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 107201410
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License Number State | CA
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