Prodigy Healthcare Inc.
Organization Active NPI Community/Behavioral Health Agency · Fresno, CA
NPI 1508311630 · NPPES record last updated Aug 18, 2016
Key facts
- NPI
- 1508311630
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- PRODIGY HEALTHCARE INC.
- Practice address
- 2888 S Ivy Ave
Fresno, CA 93706-5513 - Phone
- (559) 892-9452
- NPI assigned
- Aug 18, 2016
- Organization subpart
- No
Authorized official
- Name
- Mr. Jagdip Dhanda
- Title
- Ceo
- Phone
- (559) 892-9452
Corporate family (same tax ID) 17
Practitioners 1
National Provider Directory
- Tax ID family
- Prodigy Healthcare Inc
Locations
2888 S Ivy Ave
Fresno, CA 93706
Phone (559) 495-5607
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
2888 S Ivy Ave
Fresno, CA 93706-5513
Mailing address
PO Box 820
Fowler, CA 93625-0820
Phone (559) 892-9452
Other providers in Fresno, CA
- Pro Hospice Agency
- Pro Hospice Agency, Inc
- Chloe Larryssa Dawn Proctor
- Prodigy Healthcare Inc.
- Prodigy Healthcare Inc.
- Prodigy Healthcare Inc.
- Courtney Proen
- Nicholas Costas Proen
- Professional Health Care Inc
- Professional Healthcare Group Inc
All providers in Fresno, CA · Community/Behavioral Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.