Organization
EMINENCE HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN GARZA II (CEO/PROGRAM DIRECTOR)
(559) 221-8100
Entity
Organization
Contact information
Practice address
855 W NIELSEN AVE, ROOMS 1, 2, 3, 5, FRESNO, CA 93706-1700
(559) 221-8100
(559) 221-8101
Mailing address
PO BOX 27707, FRESNO, CA 93729-7707
(559) 221-8100
(559) 221-8101
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-6209
MEDI-CAL
CA
Enumeration date
04/06/2009
Last updated
09/21/2017
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