| NPI | 1043393713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY TATEISHI Administrator 916-451-5489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CA 340310942) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2008-06-25 |