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1043632763
CHRISTOPHER JORDAN INGRAM
GRASS VALLEY, CA
NPI
1043632763
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
2014-01-15
Last Update Date
2014-01-15
Business Address
Mr. CHRISTOPHER JORDAN INGRAM
714 W. MAIN ST
GRASS VALLEY, CA 95945
Phone number: 530-477-9800
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Mailing Address
Mr. CHRISTOPHER JORDAN INGRAM
714 W. MAIN ST
GRASS VALLEY, CA 95945
Phone number: 530-477-9800
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