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General NPI Number Information
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NPI Number | 1588950844
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Entity Type | Organization
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Legal Business Name | SMITH ADULT RESIDENTIAL CARE
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 06/24/2011
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Provider Practice Location Address
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Address Line | 1326 SIDONIA ST
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City | HANFORD
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State | CA
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Zip | 93230-6977
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Country | US
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Telephone | 559-589-1597
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Fax | 559-582-4057
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Provider Business Mailing Address
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Address Line | PO BOX 1093 318-A E 4TH STREET
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City | HANFORD
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State | CA
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Zip | 93232-1093
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Country | US
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Telephone | 559-584-8451
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Fax | 559-584-8694
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. GWENDOLYN M. SMITH
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Credential |
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Telephone | 559-584-8451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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