Provider Demographics
NPI:1386390771
Name:BALLESTEROS HELPING FAMILIES
Entity type:Organization
Organization Name:BALLESTEROS HELPING FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVV IHSS
Authorized Official - Prefix:
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:BALLESTEROS
Authorized Official - Suffix:
Authorized Official - Credentials:HHA
Authorized Official - Phone:559-216-4576
Mailing Address - Street 1:ONLINE EVV PHASE 11
Mailing Address - Street 2:ONLINE
Mailing Address - City:ARIZONA
Mailing Address - State:CA
Mailing Address - Zip Code:09433
Mailing Address - Country:US
Mailing Address - Phone:559-216-4576
Mailing Address - Fax:
Practice Address - Street 1:2635 E MCKENZIE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2433
Practice Address - Country:US
Practice Address - Phone:559-216-4576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6575667Medicaid