Provider Demographics
NPI:1912274440
Name:EMINENCE HEALTH CARE
Entity type:Organization
Organization Name:EMINENCE HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-221-8100
Mailing Address - Street 1:7170 N FINANCIAL DR
Mailing Address - Street 2:SUITE 135
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7170 N FINANCIAL DR
Practice Address - Street 2:SUITE 135
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2939
Practice Address - Country:US
Practice Address - Phone:559-221-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health