Provider Demographics
NPI:1093537318
Name:CENTERS FOR LIVING, INC
Entity type:Organization
Organization Name:CENTERS FOR LIVING, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOLLUM-COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-500-9290
Mailing Address - Street 1:335 E GETTYSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-3032
Mailing Address - Country:US
Mailing Address - Phone:559-270-6429
Mailing Address - Fax:
Practice Address - Street 1:315 E GETTYSBURG AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-3032
Practice Address - Country:US
Practice Address - Phone:559-809-2936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite Care
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder