| NPI | 1437473063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA P GABRIEL Licensee/Administrator 209-598-1436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: CA 55GP1907) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |