| NPI | 1891107231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGENIA CHIEGEONU AKA Administrator 916-600-7989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |