| NPI | 1508739525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CASSANDRA NOBLE Administrator 916-512-9646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-09-25 |