Organization
SYNCHRONY OF VISALIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWYN W ORTIZ-NANCE PSYD. (CLINICAL DIRECTOR)
(559) 635-4252
Entity
Organization
Contact information
Practice address
1041 N DEMAREE ST, VISALIA, CA 93291-4119
(559) 635-4252
(559) 635-4281
Mailing address
1041 N DEMAREE ST, VISALIA, CA 93291-4119
(559) 635-4252
(559) 635-4281
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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