Provider Demographics
NPI:1417437047
Name:HERGIE & ASSOCIATES
Entity Type:Organization
Organization Name:HERGIE & ASSOCIATES
Other - Org Name:GARDEN TERRACE ASSISTED LIVING 111
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:HERGENROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-259-2283
Mailing Address - Street 1:2145 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-8118
Mailing Address - Country:US
Mailing Address - Phone:559-297-7530
Mailing Address - Fax:559-324-0729
Practice Address - Street 1:1760 E CHENNAULT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3812
Practice Address - Country:US
Practice Address - Phone:559-297-7530
Practice Address - Fax:559-324-0729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107201085310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility