Provider Demographics
NPI:1255840708
Name:CHOWCHILLA CARE HOLDINGS, LLC
Entity Type:Organization
Organization Name:CHOWCHILLA CARE HOLDINGS, LLC
Other - Org Name:INVIGORATE POST ACUTE OF CHOWCHILLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BIGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-901-3147
Mailing Address - Street 1:4616 W MODOC CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-9384
Mailing Address - Country:US
Mailing Address - Phone:559-901-3147
Mailing Address - Fax:559-713-6072
Practice Address - Street 1:1010 VENTURA AVE
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-2368
Practice Address - Country:US
Practice Address - Phone:559-665-4826
Practice Address - Fax:559-665-4074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040000082251J00000X, 314000000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No251J00000XAgenciesNursing Care