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Organization
SHEPHERD FAMILY HOME
Active
Organization
SHEPHERD FAMILY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE W SHEPHERD (OWNER)
(559) 298-7998
Entity
Organization
Contact information
Practice address
8893 N SIERRA VISTA AVE, FRESNO, CA 93720-3948
(559) 298-7998
(559) 298-1551
Mailing address
8893 N SIERRA VISTA AVE, FRESNO, CA 93720-3948
(559) 298-7998
(559) 298-1551
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC80272G
MEDICAL PROVIDER NUMBER
CA
Enumeration date
10/04/2006
Last updated
08/22/2020
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