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General NPI Number Information
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NPI Number | 1609243690
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Entity Type | Organization
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Legal Business Name | WESTCARE CALIFORNIA, INC.
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 16083 JERSEY AVE
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City | LEMOORE
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State | CA
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Zip | 93245-9701
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Country | US
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Telephone | 559-251-4800
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Fax | 559-453-7827
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Provider Business Mailing Address
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Address Line | 1505 N CHESTNUT AVE
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City | FRESNO
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State | CA
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Zip | 93703-4504
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Country | US
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Telephone | 559-251-4800
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Fax | 559-453-7827
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Authorized Official
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Title or Position | DIRECTOR CONTRACT COMPLIANCE
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Name | MS. MARYELLEN PISTALU
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Credential | MS
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Telephone | 559-251-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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