# BONAVENTE ICF DDN HOME

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

## Provider details

- **NPI number:** 1841345782
- **Authorized official:** MRS. NIDA A. BONAVENTE (PRESIDENT)
- **Authorized official phone:** (559) 271-5245

## Contact information

- **Practice address:** 6404 N CORNELIA AVE, FRESNO, CA 93722-3645
- **Practice address phone:** (559) 271-5245
- **Practice address fax:** (559) 277-4708
- **Mailing address:** 6404 N CORNELIA AVE, FRESNO, CA 93722-3645
- **Mailing address phone:** (559) 271-5245
- **Mailing address fax:** (559) 277-4708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | CA | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 08/22/2020