| NPI | 1588830657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA MCCORMACK Licensee 408-713-2770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 230000320) |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2014-04-09 |