Organization
WIGGINS HOME 3
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN WIGGINS (ADMINISTRATOR)
(559) 781-3669
Entity
Organization
Contact information
Practice address
677 SIERRA ST, PORTERVILLE, CA 93257-5543
(559) 781-3669
Mailing address
1680 THETA CT, PORTERVILLE, CA 93257-6609
(559) 781-3669
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
040000398
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC80131F
—
CA
Enumeration date
01/10/2007
Last updated
07/23/2008
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