# TWILIGHT HAVEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427057405
- **Authorized official:** SHARON D BAILEY (ADMINISTRATOR)
- **Authorized official phone:** (559) 251-8417

## Contact information

- **Practice address:** 1717 S WINERY AVE, FRESNO, CA 93727-5011
- **Practice address phone:** (559) 251-8417
- **Practice address fax:** (559) 251-1103
- **Mailing address:** 1717 S WINERY AVE, FRESNO, CA 93727-5011
- **Mailing address phone:** (559) 251-8417
- **Mailing address fax:** (559) 251-1103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 100400622 | CA | — |
| 314000000X | Skilled Nursing Facility | 100490817 | CA | Yes |

## Other

- **Enumeration date:** 07/20/2005
- **Last updated:** 05/03/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR05658F | — | CA |