OrganizationActive
Addiction Intervention Resources
NPI 1114129814 · Children's Substance Abuse Rehabilitation Facility · Fresno, CA
Provider details
- NPI number
- 1114129814
- Entity type
- Organization
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Authorized official
- Linda Gibson, Administrator
- License
- 1006 (CA)
Practice location
405 N Broadway St
Fresno, CA 93701-1513
Phone: (559) 486-3146
Fax: (559) 486-3146
Mailing address
405 N Broadway St
Fresno, CA 93701-1513
Registry dates
- Enumerated
- 2007-06-04
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.