| NPI | 1720165368 |
|---|---|
| Doing Business As | FRUITRIDGE TRANSITIONAL HOME |
| Entity Type | Organization |
| Authorized Contact | LORI BLACKBURN Vice President 209-955-2322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |