Bonavente Icf Ddn Home
NPI #1841345782 in Fresno, California
Provider Information
- NPI Number
- 1841345782
- Entity Type
- Organization
- Organization Name
- Bonavente Icf Ddn Home
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jan 23, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 6404 N CORNELIA AVE
- City
- Fresno
- State
- California
- ZIP Code
- 93722-3645
- Phone
- (559) 271-5245
Authorized Official
- Name
- MRS. NIDA A. BONAVENTE
- Title
- PRESIDENT
- Phone
- (559) 271-5245
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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