| NPI | 1609910199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE ELAINE BRATTON Bookkeeper 916-381-1594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CA LTC60084F) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-08-29 |