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General NPI Number Information
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NPI Number | 1730070095
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Entity Type | Organization
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Legal Business Name | MADE WH-LE
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1690 W SHAW AVE STE 220
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City | FRESNO
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State | CA
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Zip | 93711-3519
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Country | US
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Telephone | 559-774-9123
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Fax |
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Provider Business Mailing Address
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Address Line | 8668 N CEDAR AVE APT 204
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City | FRESNO
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State | CA
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Zip | 93720-4809
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Country | US
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Telephone | 559-774-9123
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Fax |
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Authorized Official
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Title or Position | FOUNDER & PROGRAM DIRECTOR
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Name | FLOWER DEVINE
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Credential |
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Telephone | 559-774-9123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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