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NPI Code Detail

MEDICARE: CENTRAL VALLEY RECOVERY SERVICES, INC.

MEDICARE: CENTRAL VALLEY RECOVERY SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility540031BNCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1540031BNOTHERCASTATE OF CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES LICENSE AND CERTIFICATION

General Provider Information

NPI Number : 1801256078
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL VALLEY RECOVERY SERVICES, INC.
Provider Business Mailing Address
First Line : 120 W SCHOOL AVE
Second Line :
City : VISALIA
State : CA
Zip : 93291-4925
Country : US
Telephone Number : 559-625-4100
Fax Number : 559-625-1970
Provider Business Practice Location Address
First Line : 120 W SCHOOL AVE
Second Line :
City : VISALIA
State : CA
Zip : 93291-4925
Country : US
Telephone Number : 559-625-4100
Fax Number : 559-625-1970
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MS. SHIRLEY KLUVER
Credential : CATC
Telephone Number : 559-625-2995
Provider Enumeration Date : 03/02/2016
Last Update Date : 03/02/2016

Similar Medicare Providers

1043163850 — JACOB ROBERT MOORE RADT
Practice Location Address:
120 W SCHOOL AVE
VISALIA, CA
93291-4925
Practice Phone: 559-625-4100
Practice Fax:
1326390972 — MR. STEVE L CUMMINGS CADC II, ICADC
Practice Location Address:
120 W SCHOOL AVE
VISALIA, CA
93291-4925
Practice Phone: 559-625-4100
Practice Fax: 559-625-1970
1801255443 — MR. DAVID ALLEN ANDERSEN CADC-II ,ICADC
Practice Location Address:
120 W SCHOOL AVE
VISALIA, CA
93291-4925
Practice Phone: 559-625-4100
Practice Fax: 559-625-1970
1598126013 — BRIAN THOMAS
Practice Location Address:
120 W SCHOOL AVE
VISALIA, CA
93291-4925
Practice Phone: 559-625-4100
Practice Fax: 559-625-1970
1366987646 — ROBBIE THOMPSON I CADC-II CA
Practice Location Address:
120 W SCHOOL AVE
VISALIA, CA
93291-4925
Practice Phone: 559-625-4100
Practice Fax:
1669986626 — MR. LARRY EUGENE ANDRADE II CADC II
Practice Location Address:
120 W SCHOOL AVE
VISALIA, CA
93291-4925
Practice Phone: 559-625-4100
Practice Fax: 559-625-1970

Directions to “CENTRAL VALLEY RECOVERY SERVICES, INC. ” Practice Location

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