Provider Demographics
NPI:1811561749
Name:JAN-ROY PLACE OF FRESNO INC.
Entity Type:Organization
Organization Name:JAN-ROY PLACE OF FRESNO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIR GILROY
Authorized Official - Middle Name:B
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-940-9708
Mailing Address - Street 1:4266 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-3635
Mailing Address - Country:US
Mailing Address - Phone:559-940-9708
Mailing Address - Fax:559-797-9284
Practice Address - Street 1:4766 E ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-2636
Practice Address - Country:US
Practice Address - Phone:559-890-0839
Practice Address - Fax:559-797-9284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility