Provider Demographics
NPI:1336660414
Name:DYCORA TRANSITIONAL HEALTH & LIVING -- MEMORY CARE OF TULARE LLC
Entity Type:Organization
Organization Name:DYCORA TRANSITIONAL HEALTH & LIVING -- MEMORY CARE OF TULARE 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 1:604 E MERRITT AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2135
Practice Address - Country:US
Practice Address - Phone:559-686-1601
Practice Address - Fax:559-686-8448
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