| NPI | 1053536011 |
|---|---|
| Doing Business As | STEPHANIE'S ICF IDD N |
| Entity Type | Organization |
| Authorized Contact | ROSEMARIE TAMBOT VERIDIANO President Administrator 650-580-2983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 220000374) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |