| NPI | 1720120330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIESHA CHARLTON Billing Manager 916-422-7327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility Nursing Care, Pediatric (Licence: CA 315193) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |