| Prodigy Healthcare Non Profit | |
|
311 E Merced St Fowler CA 93625-2316 | |
| (559) 892-9452 | |
| Not Available |
| Full Name | Prodigy Healthcare Non Profit |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 311 E Merced St, Fowler, California |
| Authorized Official Name and Position | Jagdip Dhanda (CEO) |
| Authorized Official Contact | 5598929452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodigy Healthcare Non Profit 311 E Merced St Fowler CA 93625-2316 Ph: (559) 892-9452 | Prodigy Healthcare Non Profit 311 E Merced St Fowler CA 93625-2316 Ph: (559) 892-9452 |
| NPI Number | 1265158661 |
|---|---|
| Provider Enumeration Date | 10/17/2022 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265158661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |