| NPI | 1730216508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL LOUISE SOLORIO Administrator 559-788-9638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CA LTC80270F) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2023-12-04 |