| NPI | 1780206466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIMA VANHOOSE Owner 209-373-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |