Organization
COUNTY OF FRESNO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA TAYLOR RN (DIRECTOR)
(559) 600-9193
Entity
Organization
Contact information
Practice address
3133 N MILLBROOK AVE, FRESNO, CA 93703-1425
(559) 600-8918
(559) 453-5099
Mailing address
4441 E KINGS CANYON RD, FRESNO, CA 93702-3604
(559) 600-9193
(559) 253-9144
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
000001007
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000001007
—
CA
Enumeration date
01/18/2012
Last updated
01/18/2012
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