Provider Demographics
NPI: | 1619353091 |
---|---|
Name: | HARMONY HOMES INC. |
Entity type: | Organization |
Organization Name: | HARMONY HOMES INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | QIDP |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JEREMY |
Authorized Official - Middle Name: | DAVID |
Authorized Official - Last Name: | WINANS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 559-905-9806 |
Mailing Address - Street 1: | 1034 W MESA AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | FRESNO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 93711-2001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 559-449-1605 |
Mailing Address - Fax: | 559-449-1552 |
Practice Address - Street 1: | 6404 N CORNELIA AVE |
Practice Address - Street 2: | |
Practice Address - City: | FRESNO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93722-3645 |
Practice Address - Country: | US |
Practice Address - Phone: | 559-271-5245 |
Practice Address - Fax: | 559-449-1552 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-08-07 |
Last Update Date: | 2015-08-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 315P00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities |