Provider Demographics
NPI:1639652613
Name:CENTRAL VALLEY TLCF , INC.
Entity Type:Organization
Organization Name:CENTRAL VALLEY TLCF , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANYE
Authorized Official - Middle Name:LYNORA
Authorized Official - Last Name:STUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-920-0998
Mailing Address - Street 1:1760 W KANAI AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-1874
Mailing Address - Country:US
Mailing Address - Phone:559-781-5796
Mailing Address - Fax:559-783-1957
Practice Address - Street 1:1760 W KANAI AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-1874
Practice Address - Country:US
Practice Address - Phone:559-781-5796
Practice Address - Fax:559-783-1957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities