Provider Demographics
NPI:1598092652
Name:EMINENCE HEALTHCARE MONTEREY INC.
Entity Type:Organization
Organization Name:EMINENCE HEALTHCARE MONTEREY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HOWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:559-221-8100
Mailing Address - Street 1:114 E SHAW AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7621
Mailing Address - Country:US
Mailing Address - Phone:559-221-8100
Mailing Address - Fax:559-221-8101
Practice Address - Street 1:401 4TH STREET
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:CA
Practice Address - Zip Code:93926
Practice Address - Country:US
Practice Address - Phone:559-221-8100
Practice Address - Fax:559-221-8101
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMINENCE HEALTHCARE MONTEREY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder