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1033451364
MICHAELA LAKE
GRASS VALLEY, CA
NPI
1033451364
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
2013-03-25
Last Update Date
2013-03-25
Business Address
MICHAELA LAKE
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
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Mailing Address
MICHAELA LAKE
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
Copy
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