Organization
EMINENCE HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNIE JOSEPH ANDRADE (CEO)
(559) 221-8100
Entity
Organization
Contact information
Practice address
2025 N. GATEWAY BLVD. STE 104, FRESNO, CA 93727-1619
(559) 221-8100
(559) 221-8100
Mailing address
7170 N. FINANCIAL DRIVE, SUITE 135, FRESNO, CA 93720-2978
(559) 221-8100
(559) 221-8101
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101076000
DRUG MEDI-CAL
CA
Enumeration date
04/10/2007
Last updated
07/07/2011
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