Organization
THE LIVING CENTERS OF FRESNO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TROY DORMAN (PRESIDENT)
(209) 575-1580
Entity
Organization
Contact information
Practice address
4576 E SHIELDS AVE, FRESNO, CA 93726-7220
(209) 575-1580
(209) 575-2017
Mailing address
917 13TH ST, MODESTO, CA 95354-0903
(209) 575-1580
(209) 575-2017
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
100095AP
CA
Other
Enumeration date
07/29/2016
Last updated
09/15/2016
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