Provider Demographics
NPI:1740781509
Name:HONEST CITIZENS NETWORK
Entity Type:Organization
Organization Name:HONEST CITIZENS NETWORK
Other - Org Name:CCN CLOVIS
Other - Org Type:Other Name
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:AARONJACK
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:559-281-9575
Mailing Address - Street 1:1545 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-1411
Mailing Address - Country:US
Mailing Address - Phone:559-281-9575
Mailing Address - Fax:
Practice Address - Street 1:1545 5TH ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-1411
Practice Address - Country:US
Practice Address - Phone:559-281-9575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty