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1467693432
DEDRA JANENE RUSSELL
SACRAMENTO, CA
NPI
1467693432
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
(Licence: CA 340018AN)
Enumeration Date
2009-03-20
Last Update Date
2009-03-26
Business Address
-- DEDRA JANENE RUSSELL RAS
1001 GRAND AVE
SACRAMENTO, CA 95838-3512
Phone number: 916-929-1951
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Mailing Address
-- DEDRA JANENE RUSSELL RAS
PO BOX 38369
SACRAMENTO, CA 95838-0369
Phone number: 916-929-1951
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