| NPI | 1205002904 |
|---|---|
| Doing Business As | KLAMATH HOME ICF DD-N |
| Entity Type | Organization |
| Authorized Contact | ANTONIO GAGANTE RANIT President 916-721-9439 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CA 550000069) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |