| NPI | 1912190703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY W. DAVIS Owner 559-271-3431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 550000484) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2007-08-24 |