EMINENCE HEALTHCARE, INC. (NPI# 1487805586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487805586 |
| Entity Type | Organization |
| Organization Name | EMINENCE HEALTHCARE, INC. |
| Practice Address |
33280 Lodge Rd Room 4 Tollhouse CA 93667-9643 |
| Mailing Address |
Po Box 27707 Fresno CA 93729-7707 |
| Practice Telephone | 5592218100 |
| Mailing Telephone | 5592218100 |
| Mailing Fax Number | 5592218101 |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2015-01-28 |
| Authorized Official Name | MR. JUAN GARZA II (COO/PROGRAM DIRECTOR) |
| Authorized Official Telephone | 5992218100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | 106202 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417346370 | Eminence Healthcare, Inc. | Clinic/Center | 33030 Road 228, Room 5, North Fork, CA 93643-9694 | 2015-01-15 |
| 1770972705 | Eminence Healthcare, Inc. | Clinic/Center | 46655 Road 200, O'neals, CA 93645-0210 | 2015-01-14 |
| 1790174837 | Eminence Healthcare, Inc. | Clinic/Center | 33087 Road 228, Room 23, North Fork, CA 93643-9695 | 2015-01-13 |
| 1356730444 | Eminence Healthcare, Inc. | Clinic/Center | 45077 Road 200, Room 305, O'neals, CA 93645-0186 | 2015-01-13 |
| 1760615728 | Eminence Healthcare, Inc. | Clinic/Center | 305 E. C Street, Dixon, CA 95620-3000 | 2009-08-25 |
| 1508099565 | Eminence Healthcare, Inc. | Clinic/Center | 200 N. Lincoln Street, Dixon, CA 95620-3209 | 2009-08-25 |
| 1336371491 | Eminence Healthcare, Inc. | Clinic/Center | 555 College Way, Dixon, CA 95620-9301 | 2009-08-21 |
| 1083866412 | Eminence Healthcare, Inc. | Clinic/Center | 33326 Lodge Rd, Room 22, Tollhouse, CA 93667-9644 | 2008-10-16 |
| 1043469539 | Eminence Healthcare, Inc. | Clinic/Center | 6240 W Palo Alto Ave, Rm 201, 301, 801-805, Fresno, CA 93722-2001 | 2008-09-09 |
| 1942479092 | Eminence Healthcare, Inc. | Clinic/Center | 599 Fifth Street, Mcfarland, CA 93250 | 2008-02-22 |
| Street Address |
33280 LODGE RD ROOM 4 |
| City | TOLLHOUSE |
| State | CA |
| Zip Code | 93667-9643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508332560 | Kayla Clere | Case Manager/Care Coordinator | 32293 Sycamore Rd, Tollhouse, CA 93667-9504 | 2018-10-17 |
| 1053829846 | Lori Marie Harshman | Nurse Practitioner | 35885 Lodge Rd, Tollhouse, CA 93667-9624 | 2018-01-16 |
| 1083866412 | Eminence Healthcare, Inc. | Clinic/Center | 33326 Lodge Rd, Room 22, Tollhouse, CA 93667-9644 | 2008-10-16 |
| 1306238787 | Jennifer Marie Ray | Speech-Language Pathologist | 27890 Burrough Valley Rd, Tollhouse, CA 93667-9708 | 2015-02-23 |
| 1649446907 | Valerie Lynn Ingle | Licensed Vocational Nurse | 28825 Cassandra Rd, Tollhouse, CA 93667-9710 | 2008-05-06 |
| 1518208180 | Tara Nicole Townsend | Specialist | 29925 Burrough Valley Rd, Tollhouse, CA 93667-9718 | 2013-03-07 |
| 1982007811 | Kristen West | Speech-Language Pathologist | 30878 Seminole Rd, Tollhouse, CA 93667-9752 | 2014-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508332560 | Kayla Clere | Case Manager/Care Coordinator | 32293 Sycamore Rd, Tollhouse, CA 93667-9504 | 2018-10-17 |
| 1053829846 | Lori Marie Harshman | Nurse Practitioner | 35885 Lodge Rd, Tollhouse, CA 93667-9624 | 2018-01-16 |
| 1306238787 | Jennifer Marie Ray | Speech-Language Pathologist | 27890 Burrough Valley Rd, Tollhouse, CA 93667-9708 | 2015-02-23 |
| 1982007811 | Kristen West | Speech-Language Pathologist | 30878 Seminole Rd, Tollhouse, CA 93667-9752 | 2014-10-06 |
| 1518208180 | Tara Nicole Townsend | Specialist | 29925 Burrough Valley Rd, Tollhouse, CA 93667-9718 | 2013-03-07 |
| 1083866412 | Eminence Healthcare, Inc. | Clinic/Center | 33326 Lodge Rd, Room 22, Tollhouse, CA 93667-9644 | 2008-10-16 |
| 1649446907 | Valerie Lynn Ingle | Licensed Vocational Nurse | 28825 Cassandra Rd, Tollhouse, CA 93667-9710 | 2008-05-06 |
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083866412 | Eminence Healthcare, Inc. | Clinic/Center | 33326 Lodge Rd, Room 22, Tollhouse, CA 93667-9644 | 2008-10-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.