| NPI | 1700623626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANNE DE LOS SANTOS Administrator 916-213-3688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-09 |