| NPI | 1386283984 |
|---|---|
| Doing Business As | FAIR OAKS MANOR III |
| Entity Type | Organization |
| Authorized Contact | TEODULO BONZON Manager 818-846-4469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2019-12-30 |