Provider Demographics
NPI:1558945253
Name:NEW PASSAGES
Entity Type:Organization
Organization Name:NEW PASSAGES
Other - Org Name:PURVIS HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-317-5772
Mailing Address - Street 1:1175 SHAW AVE STE 232
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3932
Mailing Address - Country:US
Mailing Address - Phone:559-288-3548
Mailing Address - Fax:
Practice Address - Street 1:1678 PURVIS AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-3027
Practice Address - Country:US
Practice Address - Phone:559-324-1572
Practice Address - Fax:559-369-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-08
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness