Provider Demographics
NPI:1912348194
Name:FRESNO COUNTY HISPANIC COMMISSION
Entity Type:Organization
Organization Name:FRESNO COUNTY HISPANIC COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:559-485-0501
Mailing Address - Street 1:1414 W KEARNEY BLVD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-2702
Mailing Address - Country:US
Mailing Address - Phone:559-485-0501
Mailing Address - Fax:559-485-1313
Practice Address - Street 1:1414 W KEARNEY BLVD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-2702
Practice Address - Country:US
Practice Address - Phone:559-485-0501
Practice Address - Fax:559-485-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100006A5324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility