FRESNO SKILLED NURSING & WELLNSS CENTRE, LLC (NPI# 1104064575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104064575 |
| Entity Type | Organization |
| Organization Name | FRESNO SKILLED NURSING & WELLNSS CENTRE, LLC |
| Other Organization Name | HEALTHCARE CENTRE OF FRESNO |
| Practice Address |
1665 M St Fresno CA 93721-1121 |
| Practice Telephone | 5592685361 |
| Practice Fax Number | 3236341943 |
| Mailing Telephone | 5592685361 |
| Mailing Fax Number | 3236341943 |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2012-10-02 |
| Authorized Official Name | CHAIM KOLODNY (SR. VICE PRESIDENT) |
| Authorized Official Telephone | 3236341940 |
| Authorized Official Credential | NHA, CMC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 040000200 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZR05626F | 05 |
| Other Name | Type Code |
|---|---|
| Healthcare Centre of Fresno | Doing Business As Name - Organization |
| Street Address |
1665 M ST |
| City | FRESNO |
| State | CA |
| Zip Code | 93721-1121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376625889 | Hope Manor Incorporated | Skilled Nursing Facility | 1665 M St, Fresno, CA 93721-1121 | 2006-10-20 |
| 1477101145 | Chason Woods | Occupational Therapist | 1665 M St, Fresno, CA 93721-1121 | 2019-08-27 |
| 1396398988 | Randy Williams | Physical Therapy Assistant | 1665 M St, Fresno, CA 93721-1121 | 2019-07-22 |
| 1598317968 | Chad Leon Tidwell | Occupational Therapist | 1665 M St, Fresno, CA 93721-1121 | 2019-07-15 |
| 1629532320 | Gregory Richard Wiegers | Physical Therapy Assistant | 1665 M St, Fresno, CA 93721-1121 | 2019-01-27 |
| 1720443823 | Kourtney Jackson | Occupational Therapist | 1665 M St, Fresno, CA 93721-1121 | 2015-12-16 |
| 1184025074 | Rehab of Fresno Assisted Living, LLC | Assisted Living Facility | 1665 M St, Fresno, CA 93721-1121 | 2014-09-10 |
| 1801190632 | Rachel Moore | Occupational Therapist | 1665 M St, Fresno, CA 93721-1121 | 2011-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
| 1619521929 | Kepler Education Incorporation | Local Education Agency (LEA) | 1462 Broadway St., Fresno, CA 93721 | 2019-07-25 |
| 1588156434 | Micha Ramirez | Case Manager/Care Coordinator | 2140 Merced St., Fresno, CA 93721 | 2018-06-05 |
| 1649798992 | Nadia C Martinez | Licensed Vocational Nurse | 1310 M. Street, Fresno, CA 93721 | 2017-09-07 |
| 1538604251 | Be Together Home Care LLC | In Home Supportive Care | 2014 Tulare St Ste 605, Fresno, CA 93721 | 2017-01-04 |
| 1124426705 | Central California Faculty Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2554 Merced Street, Fresno, CA 93721 | 2014-12-12 |
| 1427455336 | University Medical Supply | Durable Medical Equipment & Medical Supplies | 2554 Merced St, Fresno, CA 93721 | 2014-11-21 |
| 1154723542 | Ryan Gil | Physical Therapist | 1350 O St Ste 201, Fresno, CA 93721 | 2014-09-17 |
| 1831526250 | Tiffany Marie Gonzalez | Counselor | 2409 Mered St #106, Fresno, CA 93721 | 2013-09-30 |
| 1972939783 | Reshale L Thomas | Psychologist | 2900 Fresno St Ste 108, Fresno, CA 93721 | 2013-09-25 |
| Find all providers in zip 93721 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598308850 | Acme Care, Inc | Skilled Nursing Facility | 6253 N Colonial Ave, Fresno, CA 93704-1437 | 2019-10-18 |
| 1245779305 | Senior Med Care Living Inc | Skilled Nursing Facility | 2275 N Saratoga Ave, Fresno, CA 93722-4696 | 2017-02-21 |
| 1952766693 | Fresno Postacute Care LLC | Skilled Nursing Facility | 1233 A St., Fresno, CA 93706-3202 | 2015-12-23 |
| 1548625718 | Northern California Congregate Living, Inc | Skilled Nursing Facility | 5321 W Roberts Ave, Fresno, CA 93722-7737 | 2015-12-15 |
| 1306213517 | Babujyan Healthcare, Inc. | Skilled Nursing Facility | 1419 W Bullard Ave, Fresno, CA 93711-2324 | 2015-08-24 |
| 1346623378 | Mehdi Hakimipour Md, Inc. | Skilled Nursing Facility | 315 E Nees Ave, #124, Fresno, CA 93720-2062 | 2015-07-08 |
| 1720499908 | Affinity Congregate Living, Inc | Skilled Nursing Facility | 3150 E Shields Ave, Fresno, CA 93726-6901 | 2014-05-10 |
| 1134480817 | Humangood Fresno | Skilled Nursing Facility | 5551 N Fresno St, Fresno, CA 93710 | 2012-05-30 |
| 1528100013 | Covenant Care California, LLC | Skilled Nursing Facility | 577 South Peach Avenue, Fresno, CA 93727-3952 | 2007-02-13 |
| 1336287077 | Manning Gardens Care Center Inc | Skilled Nursing Facility | 2113 E Manning Ave, Fresno, CA 93725-9681 | 2007-02-02 |
| Find all providers in FRESNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.