Provider Demographics
NPI:1346620374
Name:CENTRAOL VALLEY RECOVERY SERVICES, INC.
Entity Type:Organization
Organization Name:CENTRAOL VALLEY RECOVERY SERVICES, INC.
Other - Org Name:MOTHERING HEIGHTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:WOMEN'S SERVICES DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:ZARATE-PINA
Authorized Official - Suffix:
Authorized Official - Credentials:CADC II-CAS
Authorized Official - Phone:559-635-8010
Mailing Address - Street 1:320 W OAK AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4929
Mailing Address - Country:US
Mailing Address - Phone:559-625-2995
Mailing Address - Fax:559-625-3808
Practice Address - Street 1:705 S COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-2727
Practice Address - Country:US
Practice Address - Phone:559-635-8010
Practice Address - Fax:559-635-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA540031DN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility