Provider Demographics
NPI:1952169617
Name:FRESNO HOME CARE INC
Entity type:Organization
Organization Name:FRESNO HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEGHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KRDIKASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-230-9604
Mailing Address - Street 1:315 L ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-3111
Mailing Address - Country:US
Mailing Address - Phone:559-475-0645
Mailing Address - Fax:
Practice Address - Street 1:315 L ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-3111
Practice Address - Country:US
Practice Address - Phone:559-475-0645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health