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General NPI Number Information
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NPI Number | 1497685044
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Entity Type | Organization
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Legal Business Name | AWAKENED HEARTS FOUNDATION
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Dates
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Enumeration Date | 05/22/2026
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Last Update Date | 05/22/2026
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Provider Practice Location Address
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Address Line | 2350 W SHAW AVE STE 123
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City | FRESNO
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State | CA
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Zip | 93711-3412
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Country | US
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Telephone | 559-978-4484
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 W SHAW AVE STE 123
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City | FRESNO
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State | CA
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Zip | 93711-3412
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Country | US
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Telephone | 559-978-4484
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN FEDELE III
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Credential | SUDRC
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Telephone | 559-978-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 167G00000X
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Taxonomy Name | Licensed Psychiatric Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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