NPI | 1316164379 |
---|---|
Doing Business As | DBA ESTRELCA'S ICF/DD-H |
Entity Type | Organization |
Authorized Contact | ESTRELLA L. JOSE Licensee/Admin 209-462-4239 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: CA 100000685) |
Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care (Licence: CA 100000685) |
Enumeration Date | 2007-04-19 |
Last Update Date | 2008-07-14 |