Organization
HASSIBAH - TLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LIONEL SMITH (BUSINESS ADMINISTRATOR)
(559) 454-1337
Entity
Organization
Contact information
Practice address
345 S LOCAN AVE, FRESNO, CA 93727-9750
(559) 454-1337
(559) 233-0356
Mailing address
345 S LOCAN AVE, FRESNO, CA 93727-9750
(559) 454-1337
(559) 233-0356
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
10/21/2005
Last updated
08/22/2020
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