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WIGGINS HOME #3

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. EVELYN M WIGGINS (ADMINISTRATOR)
(559) 781-3669
Entity
Organization

Contact information

Practice address
677 SIERRA ST, PORTERVILLE, CA 93257-5543
(559) 783-0732
(559) 791-0673
Mailing address
1012 VANDALIA AVE, PORTERVILLE, CA 93257-5550
(559) 781-3669
(559) 791-0673

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
CA
315P00000X
Intellectual Disabilities Intermediate Care Facility

Other

Enumeration date
05/01/2007
Last updated
08/22/2020
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