| NPI | 1124178983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL LOUISE SOLORIO RN /Administrator 559-788-9638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: CA 120000637) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2023-11-30 |