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General NPI Number Information
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NPI Number | 1912282310
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Entity Type | Organization
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Legal Business Name | DUNAMIS INC GROUP HOMES
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 1292 N 9TH ST
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City | FRESNO
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State | CA
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Zip | 93703-4229
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Country | US
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Telephone | 281-782-5887
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Fax |
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Provider Business Mailing Address
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Address Line | 823 W SUSSEX WAY
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City | FRESNO
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State | CA
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Zip | 93705-2021
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ORLANDO GILLAM
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Credential |
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Telephone | 281-782-5887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 106215
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License Number State | CA
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