| NPI | 1386293751 |
|---|---|
| Doing Business As | GLACIER WAY HOME |
| Entity Type | Organization |
| Authorized Contact | MELANIE MALLARI PADERNA Corporate Secretary 650-580-1914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2020-08-25 |