Provider Demographics
NPI:1407513278
Name:DEANNA'S PLACE
Entity Type:Organization
Organization Name:DEANNA'S PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BENOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-905-5361
Mailing Address - Street 1:951 E ALLUVIAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2516
Mailing Address - Country:US
Mailing Address - Phone:559-905-5361
Mailing Address - Fax:
Practice Address - Street 1:951 E ALLUVIAL AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2516
Practice Address - Country:US
Practice Address - Phone:559-905-5361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility