# DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Veterans Home of California - Fresno
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770903775
- **Authorized official:** MR. LAWRENCE IMPERIAL (ADMINISTRATOR)
- **Authorized official phone:** (559) 493-4226

## Contact information

- **Practice address:** 2811 W CALIFORNIA AVE, FRESNO, CA 93706-2307
- **Practice address phone:** (559) 493-4248
- **Practice address fax:** (559) 493-4249
- **Mailing address:** PO BOX 942895, SACRAMENTO, CA 94295-0001
- **Mailing address phone:** (916) 657-9349
- **Mailing address fax:** (916) 653-1795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 107206701 | CA | — |
| 314000000X | Skilled Nursing Facility | 550002640 | CA | Yes |

## Other

- **Enumeration date:** 04/17/2014
- **Last updated:** 07/26/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 555900 | MEDICARE | CA |