KING OF KINGS MEN'S RECOVERY HOME (NPI# 1710247762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710247762 |
| Entity Type | Organization |
| Organization Name | KING OF KINGS MEN'S RECOVERY HOME |
| Practice Address |
2267 S Geneva Ave Fresno CA 93706-4326 |
| Practice Telephone | 5592666449 |
| Practice Fax Number | 5592661532 |
| Mailing Telephone | 5592666449 |
| Mailing Fax Number | 5592661532 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2012-05-24 |
| Authorized Official Name | MR. ROBERT SINGLETON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5594420400 |
| Authorized Official Credential | CAS I |
| Is Organization Subpart | Y |
| Parent Organization Name | KING OF KINGS COMMUNITY CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 100024AN | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962833111 | King of Kings Men's Recovery Home | Substance Abuse Rehabilitation Facility | 2267 S Geneva Ave, Fresno, CA 93706-4326 | 2013-12-12 |
| Street Address |
2267 S GENEVA AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93706-4326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497284442 | Alexander R Alvarez | Counselor | 2267 S Geneva Ave, Fresno, CA 93706-4326 | 2017-06-05 |
| 1942737812 | Kylen A Osborne | Counselor | 2267 S Geneva Ave, Fresno, CA 93706-4326 | 2017-05-22 |
| 1962833111 | King of Kings Men's Recovery Home | Substance Abuse Rehabilitation Facility | 2267 S Geneva Ave, Fresno, CA 93706-4326 | 2013-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295378446 | Caussaundra Maria Dominguez | Counselor | 2772 S Martin Luther King, Fresno, CA 93706 | 2019-10-21 |
| 1881244945 | Aurelio Mendoza | Counselor | 1414 W. Kearney Blvd, Fresno, CA 93706 | 2019-09-19 |
| 1003374539 | Jasmine Elizabeth Flores | Counselor | 2772 S Martin Luther King Junior Blvd, Fresno, CA 93706 | 2019-03-04 |
| 1063982049 | Bruno Sivongxay | Counselor | 2772 South Martin L King Jr Blvd, Fresno, CA 93706 | 2018-12-03 |
| 1821567538 | Misty Dawn Shepherd | Counselor | 2772 Martin L King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1497224125 | Jose Jimenez | Counselor | 2772 Martin L. King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1023587730 | James John Pokorny IIi | Counselor | 2772 Martin L. King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1932574225 | Brandi Leos | Counselor | 2772 Mlk Jr. Blvd, Fresno, CA 93706 | 2015-12-11 |
| 1174998199 | Jeremiah Hinojosa | Counselor | 2772 S M.l.k. Jr Blvd, Fresno, CA 93706 | 2015-12-02 |
| 1538534557 | Megan Mahoney | Counselor | 2772 S Martin Luther King Jr Blvd, Fresno, CA 93706 | 2015-12-02 |
| Find all providers in zip 93706 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1023626694 | My Time Recovery, LLC | Substance Abuse Rehabilitation Facility | 1015 E Indianapolis Ave, Fresno, CA 93704-3819 | 2020-07-20 |
| 1659826287 | Comprehensive Addiction Program | Substance Abuse Rehabilitation Facility | 2492 S Backer Ave, Fresno, CA 93725-1605 | 2016-08-24 |
| 1275088817 | Comprehensive Addiction Program | Substance Abuse Rehabilitation Facility | 4647 N Chestnut Ave Apt 101, Fresno, CA 93726-1803 | 2016-08-24 |
| 1588067912 | Sierra Tribal Consortium, Inc. | Substance Abuse Rehabilitation Facility | 610 W Mckinley Ave, Fresno, CA 93728-1425 | 2014-09-30 |
| 1104245489 | Dunamis, Inc. Group Home | Substance Abuse Rehabilitation Facility | 1509 N Maroa Ave, Fresno, CA 93728-1815 | 2014-04-15 |
| 1720221443 | Comprehensive Addiction Programs Inc | Substance Abuse Rehabilitation Facility | 2445 W Whitesbridge Road, Fresno, CA 93706-1225 | 2009-04-10 |
| 1497939441 | Westcare California, Inc. | Substance Abuse Rehabilitation Facility | 2855 W. Whitesbridge Road, Fresno, CA 93706 | 2007-12-27 |
| 1407064843 | Universal Health Network and Systems, Inc. | Substance Abuse Rehabilitation Facility | 3170 N Chestnut Ave, Suite 105, Fresno, CA 93703 | 2007-05-18 |
| 1861610735 | Eleventh Hour Rehabilitation Programs | Substance Abuse Rehabilitation Facility | 5639 E Park Circle Dr, Fresno, CA 93727-5413 | 2007-04-23 |
| Find all providers in FRESNO | ||||
Please comment or provide details below to improve the information on KING OF KINGS MEN'S RECOVERY HOME.
| 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.