| NPI | 1063957041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM TOPLEAN Owner 916-806-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: CA 347003747) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: CA 347003754) |
| 311Z00000X Custodial Care Facility (Licence: CA 347001289) | |
| 311Z00000X Custodial Care Facility (Licence: CA 347004184) | |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2016-12-29 |