Organization
DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA
Active
Other names
Veterans Home of California - Fresno
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE IMPERIAL (ADMINISTRATOR)
(559) 493-4226
Entity
Organization
Contact information
Practice address
2811 W CALIFORNIA AVE, FRESNO, CA 93706-2307
(559) 493-4248
(559) 493-4249
Mailing address
PO BOX 942895, SACRAMENTO, CA 94295-0001
(916) 657-9349
(916) 653-1795
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
107206701
CA
314000000X
Skilled Nursing Facility
Primary
550002640
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
555900
MEDICARE
CA
Enumeration date
04/17/2014
Last updated
07/26/2017
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