Provider Demographics
NPI:1689742538
Name:WICK FINANCIAL CORPORATION
Entity Type:Organization
Organization Name:WICK FINANCIAL CORPORATION
Other - Org Name:VISALIA NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:00005701
Authorized Official - Phone:559-732-1020
Mailing Address - Street 1:1925 E. HOUSTON AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292
Mailing Address - Country:US
Mailing Address - Phone:559-732-1020
Mailing Address - Fax:559-732-6937
Practice Address - Street 1:1925 E HOUSTON AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-2345
Practice Address - Country:US
Practice Address - Phone:559-732-1020
Practice Address - Fax:559-732-6937
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WICK FINANCIAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-30
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120000586314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT05604FMedicaid
CA055604Medicare UPIN
CA055604Medicare ID - Type UnspecifiedPROVIDER NO.