Provider Demographics
NPI:1255852331
Name:DYCORA TRANSITIONAL HEALTH & LIVING -- VISALIA LLC
Entity Type:Organization
Organization Name:DYCORA TRANSITIONAL HEALTH & LIVING -- VISALIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-430-3901
Mailing Address - Street 1:650 W ALLUVIAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-5507
Mailing Address - Country:US
Mailing Address - Phone:559-430-3901
Mailing Address - Fax:559-430-3995
Practice Address - Street 1:3710 W TULARE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-1732
Practice Address - Country:US
Practice Address - Phone:559-732-2244
Practice Address - Fax:559-732-0243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility