Provider Demographics
NPI:1275702334
Name:LAVANG CARE HOMES INC
Entity Type:Organization
Organization Name:LAVANG CARE HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WINANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-299-4954
Mailing Address - Street 1:55 SHAW AVE
Mailing Address - Street 2:SUITE 122
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3819
Mailing Address - Country:US
Mailing Address - Phone:559-299-4954
Mailing Address - Fax:559-299-0345
Practice Address - Street 1:5938 E SAGINAW WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-7974
Practice Address - Country:US
Practice Address - Phone:559-293-4535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities