in San Rafael - Intermediate Care Facility, Intellectual Disabilities
- NPI 1528225455
is a Intermediate Care Facility, Intellectual Disabilities in San Rafael, California. practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for is 1528225455. The last update date is .
's current location address is 100 Smith Ranch Rd, San Rafael, California. You can contact this provider via phone number 4154722373 and fax number 4154725739. The mailing address for is 100 Smith Ranch Rd, San Rafael, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 100 Smith Ranch Rd, San Rafael, California |
| Phone Number | 4154722373 |
| Fax Number | 4154725739 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1528225455 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 100 Smith Ranch Rd |
|---|---|
| City | San Rafael |
| State | California (CA) |
| Post Code | 949031900 |
| Phone Number | 4154722373 |
| Fax Number | 4154725739 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 100372 |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| LTC60072F | CA | -- | |
| 6205713 | CA | -- |
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