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1023433463
MIA DAVIS
GRASS VALLEY, CA
NPI
1023433463
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
2014-02-21
Last Update Date
2014-02-21
Business Address
-- MIA DAVIS
714 W. MAIN ST
GRASS VALLEY, CA 95945
Phone number: 530-477-9800
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Mailing Address
-- MIA DAVIS
714 W. MAIN ST
GRASS VALLEY, CA 95945
Phone number: 530-477-9800
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