Organization
PRODIGY HEALTHCARE, INC.
Active
Parent organization
PRODIGY HEALTHCARE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRODIGY HEALTHCARE, INC.
Authorized official
JAGDIP DHANDA (CEO)
(559) 892-9452
Entity
Organization
Contact information
Practice address
1 TILLER AVE., CARUTHERS, CA 93609
(559) 892-9452
Mailing address
PO BOX 820, FOWLER, CA 93625-0820
(559) 892-9452
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/23/2015
Last updated
05/05/2015
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