| NPI | 1770940033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESITA LOMENDEHE Licensee 916-567-0759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: CA 347001484) |
| Enumeration Date | 2016-01-18 |
| Last Update Date | 2016-01-18 |