Eminence Healthcare, Inc.
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Selma, CA
NPI 1831242494 · NPPES record last updated Mar 25, 2015
Key facts
- NPI
- 1831242494
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- Legal business name
- EMINENCE HEALTHCARE, INC.
- Practice address
- 3125 Wright St
RM 410,907a,1508,Library,Archive,Cowboy Central,Busi...
Selma, CA 93662-2429 - Phone
- (559) 221-8100
- Fax
- (559) 221-8101
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Juan Garza II
- Title
- Coo/Program Director
- Phone
- (559) 221-8100
Corporate family (same tax ID) 20
National Provider Directory
- Tax ID family
- Eminence Healthcare Inc
Locations
3125 Wright St
Rm 410907A1508
Selma, CA 93662
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Yes |
Addresses
Primary practice location
3125 Wright St
RM 410,907a,1508,Library,Archive,Cowboy Central,Busi...
Selma, CA 93662-2429
Mailing address
PO Box 27707
Fresno, CA 93729-7707
Phone (559) 221-8100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101076 | Other | CA | DRUG MEDI-CAL |
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- Susanne Af Eidal
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- Eminence Healthcare, Inc.
- Eminence Healthcare, Inc.
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- Bert Felt Engstrom
- David Melvin Engstrom
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All providers in Selma, CA · Substance Use Disorder Rehabilitation Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2015. 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.