Organization · Type 2 NPI

State of California - Department of Developmental Services

Intellectual Disabilities Intermediate Care Facility · Porterville, CA

NPI number 1982990206 Active

Practice location

26501 Avenue 140
Porterville, CA 93257-9109

Call (559) 782-2222 Map

Fax (559) 782-5630

Mailing address

PO Box 944202, 1600 9th Street Room 205
Sacramento, CA 94244-2020

Specialties and licenses

Taxonomy	Code	License
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	170000837 (CA)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

20 other providers at this address

Other intellectual disabilities intermediate care facility providers in Porterville

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NPI record

NPI: 1982990206
Entity type: Organization (Type 2)
Issued: Jun 24, 2011
Last updated: Jun 24, 2011
Status: Active
Subpart: Yes of State of California - Department of Developmental Services

Other names

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Porterville Developmental Center · doing business as

Authorized official

Ms. Patricia Flannery
Deputy Director
(916) 654-2232

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1982990206

State of California - Department of Developmental Services's National Provider Identifier is 1982990206, issued on Jun 24, 2011. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Porterville, CA. The record was last updated on Jun 24, 2011.