Provider Demographics
NPI:1245319961
Name:FRESNO COUNTY HISPANIC COMMISSION
Entity type:Organization
Organization Name:FRESNO COUNTY HISPANIC COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMINGO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:559-268-6480
Mailing Address - Street 1:1803 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1047
Mailing Address - Country:US
Mailing Address - Phone:559-268-6480
Mailing Address - Fax:559-237-5122
Practice Address - Street 1:1803 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1047
Practice Address - Country:US
Practice Address - Phone:559-268-6480
Practice Address - Fax:559-237-5122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100006AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100006ANOtherSTATE LICENSE NUMBER
CA100006ANOtherSTATE LICENSE NUMBER