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PROVIDIAN RESIDENTIAL CARE SERVICES INC. NPI 1922382290


NPI Information

NPI: 1922382290
Provider Name: PROVIDIAN RESIDENTIAL CARE SERVICES, INC.

Doing Business As: FILLMORE CHRISTIAN GARDEN

Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

Address:
4826 E FILLMORE AVE
FRESNO, CA
ZIP 93727
Phone: (559) 284-6183
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PROVIDIAN RESIDENTIAL CARE SERVICES, INC. is an assisted living and mental illness assisted living facility in Fresno, CA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. PROVIDIAN RESIDENTIAL CARE SERVICES, INC. NPI is 1922382290. The provider is registered as an organization entity type.
The provider Is Doing Business As Fillmore Christian Garden.

The provider's business location address is:

4826 E FILLMORE AVE
FRESNO, CA
ZIP 93727-701
Phone: (559) 284-6183
Fax: (559) 452-1536

The provider's authorized official is Carmen Jamili Milly .
The authorized official title is Accountant/owner and has the following contact phone number (559) 284-6183.

The enumeration date for this NPI number is 10/5/2011 and was last updated on 2/7/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13104A0625XAssisted Living FacilityAssisted Living, Mental Illness107202478CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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