| NPI | 1700963394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELITA P. SANTOS Licensee, Admistrator 916-488-4459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-06-29 |