FRESNO CONGREGATE LIVING INC (NPI# 1174014153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174014153 |
| Entity Type | Organization |
| Organization Name | FRESNO CONGREGATE LIVING INC |
| Other Organization Name | FRESNO CONGREGATE LIVING INC |
| Practice Address |
3110 E Sierra Ave Fresno CA 93710-5917 |
| Practice Telephone | 5592701073 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |
| Authorized Official Name | SVETLANA KRBOYAN (PRESIDENT/CEO) |
| Authorized Official Telephone | 5592701073 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Fresno Congregate Living Inc | Doing Business As Name - Organization |
| Street Address |
3110 E SIERRA AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93710-5917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184240384 | Patsy Joan Perry | Counselor | Quality Family Services - Sample House, 643 E. Sample Avenue, Fresno, CA 93710 | 2020-06-23 |
| 1831739853 | Blanca Stephanie Millan | Counselor | 1300 E Shaw Ave Suite 172, Fresno, CA 93710 | 2020-01-07 |
| 1679115737 | Abel Luis Flores | Physical Therapy Assistant | 5556 N Fresno St, 5555 N Fresno St, Fresno, CA 93710 | 2019-10-10 |
| 1316408933 | Simranjit Kaur Mann | Behavioral Analyst | 5180 North Primitivo Way Appt #363, Fresno, CA 93710 | 2019-03-27 |
| 1093274169 | Aleajndra Bedolla Alcantar | Behavior Technician | 1320 East Shaw Ave, #110, Fresno, CA 93710 | 2019-03-18 |
| 1790244960 | Alondra Martinez | Behavior Technician | 1320 East Shaw Ave #110, Fresno, CA 93710 | 2019-03-18 |
| 1235698622 | Irma Joselyn Castro | Behavior Technician | 1320 East Shaw Ave # 110, Fresno, CA 93710 | 2019-03-15 |
| 1619433711 | Beacon Dental Group | Dentist | 6099 N. First Ste Ste 102, Fresno, CA 93710 | 2019-02-13 |
| 1265909394 | Pathana Phonesy | Behavior Technician | 5363 N. Fresno St., Suite 105, Fresno, CA 93710 | 2018-10-26 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| Find all providers in zip 93710 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518515618 | Dashonia Shaw | Residential Treatment Facility, Physical Disabilities | 3053 N Delno Ave, Fresno, CA 93705-4015 | 2019-08-31 |
| 1225384936 | Sierra Palace for Elderly, Inc | Residential Treatment Facility, Physical Disabilities | 607 E Sierra Ave, Fresno, CA 93710-3925 | 2012-07-31 |
| 1750681177 | Kaying Lo | Residential Treatment Facility, Physical Disabilities | 5938 E Dakota Ave, Fresno, CA 93727-7916 | 2010-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881217974 | At Awe LLC | Residential Treatment Facility, Physical Disabilities | 10876 Morning Ridge Dr, Moreno Valley, CA 92557-4202 | 2020-05-22 |
| 1558980896 | Viewcrest Congregate Living | Residential Treatment Facility, Physical Disabilities | 7831 Melita Ave, North Hollywood, CA 91605-1820 | 2020-04-15 |
| 1962046524 | Randy Sarnillo Morelos | Residential Treatment Facility, Physical Disabilities | 9152 Chianti Circle, Stockton, CA 95212 | 2019-11-06 |
| 1114572385 | Twet, LLC | Residential Treatment Facility, Physical Disabilities | 1682 Daybreak Pl, Escondido, CA 92027-1023 | 2019-08-05 |
| 1144873308 | Resurgence California, LLC | Residential Treatment Facility, Physical Disabilities | 3129 Pierce Ave, Costa Mesa, CA 92626-2827 | 2019-07-17 |
| 1891352019 | Mountain View Congregate Living, Inc. | Residential Treatment Facility, Physical Disabilities | 9001 Riderwood Dr, Sunland, CA 91040-2628 | 2019-05-22 |
| 1871090803 | Prestige Care Center | Residential Treatment Facility, Physical Disabilities | 474 Sunday Dr, Turlock, CA 95382-9625 | 2018-04-06 |
| 1699281584 | Derani Congregate Living, Inc. | Residential Treatment Facility, Physical Disabilities | 7344 Etiwanda Ave, Reseda, CA 91335-3103 | 2017-12-14 |
| 1336661057 | Tak Care | Residential Treatment Facility, Physical Disabilities | 2280 N Girasol Ave, Palm Springs, CA 92262-2885 | 2017-07-14 |
| 1437682770 | Lpm Healthcare, Inc. | Residential Treatment Facility, Physical Disabilities | 12045 Lakewood Blvd, Downey, CA 90242-2635 | 2017-04-04 |
| Find all providers with the same taxonomy | ||||
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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.