Provider Demographics
NPI:1114715687
Name:FIVE RIVERS HEALTH CARE CENTER INC
Entity type:Organization
Organization Name:FIVE RIVERS HEALTH CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:REDUBLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-313-5718
Mailing Address - Street 1:3985 N FRESNO ST STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4000
Mailing Address - Country:US
Mailing Address - Phone:559-313-5718
Mailing Address - Fax:
Practice Address - Street 1:3985 N FRESNO ST STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4000
Practice Address - Country:US
Practice Address - Phone:559-481-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health