| NPI | 1043419971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY VALLONE Administrator 916-416-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CA LTC60808G) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-07-11 |