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Organization
PROVIDIAN RESIDENTIAL CARE SERVICES, INC.
Active
Organization
PROVIDIAN RESIDENTIAL CARE SERVICES, INC.
Active
Other names
Fillmore Christian Garden
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARMEN JAMILI MILLY (ACCOUNTANT/OWNER)
(559) 284-6183
Entity
Organization
Contact information
Practice address
4826 E FILLMORE AVE, FRESNO, CA 93727-3701
(559) 284-6183
(559) 452-1536
Mailing address
4826 E FILLMORE AVE, FRESNO, CA 93727-3701
(559) 284-6183
(559) 452-1536
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
107202478
CA
Other
Enumeration date
10/05/2011
Last updated
02/07/2012
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