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General NPI Number Information
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NPI Number | 1487654646
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Entity Type | Organization
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Legal Business Name | CALIFORNIA HOME FOR THE AGED, INC.
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6720 E KINGS CANYON RD
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City | FRESNO
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State | CA
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Zip | 93727-3603
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Country | US
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Telephone | 559-251-8414
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Fax | 559-251-5766
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Provider Business Mailing Address
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Address Line | 6720 E KINGS CANYON RD
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City | FRESNO
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State | CA
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Zip | 93727-3603
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Country | US
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Telephone | 559-251-8414
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Fax | 559-251-5766
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MATTHEW DEMCHUK
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Credential |
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Telephone | 559-251-8414
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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 |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | CA
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