| NPI | 1295947216 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | REYNALDO M QUEDADO Owner 408-929-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA LTC60921F) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |