| NPI | 1639738297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI BLACKBURN CAO/Treasurer 209-955-2322 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2019-06-07 |