Provider Demographics
NPI:1538955893
Name:SUNCROSS FOUNDATION LLC
Entity type:Organization
Organization Name:SUNCROSS FOUNDATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEVORK
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYADJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-917-5336
Mailing Address - Street 1:2329 E ASHLAN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-3102
Mailing Address - Country:US
Mailing Address - Phone:559-917-5336
Mailing Address - Fax:
Practice Address - Street 1:2329 E ASHLAN AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-3102
Practice Address - Country:US
Practice Address - Phone:559-917-5336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME SHELTER COMMUNITY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty