Organization
WIGGINS HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELYSIA M BOYD (SOLE PROPRIETOR)
(559) 350-0141
Entity
Organization
Contact information
Practice address
677 SIERRA ST, PORTERVILLE, CA 93257-5543
(559) 783-0732
Mailing address
2487 CRICKELWOOD CT, PORTERVILLE, CA 93257-6944
(559) 350-0141
(559) 789-9565
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
040000398
CA
Other
Enumeration date
06/05/2012
Last updated
02/23/2015
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