Provider Demographics
NPI:1366817041
Name:FRESNO ARC HOSPICE INC
Entity Type:Organization
Organization Name:FRESNO ARC HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-901-8818
Mailing Address - Street 1:5105 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-7443
Mailing Address - Country:US
Mailing Address - Phone:559-448-0777
Mailing Address - Fax:559-448-0778
Practice Address - Street 1:5105 E DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-7443
Practice Address - Country:US
Practice Address - Phone:559-448-0777
Practice Address - Fax:559-448-0778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based