Jessica Boucher in Grass Valley - Residential Treatment Facility, Emotionally Disturbed Children
Jessica Boucher - NPI 1205042496
Jessica Boucher is a Residential Treatment Facility, Emotionally Disturbed Children in Grass Valley, California. Jessica Boucher practices all healthcare services and medical treatments related to Residential Treatment Facility, Emotionally Disturbed Children. The NPI Number for Jessica Boucher is 1205042496. The last update date is 2007-07-08.
Jessica Boucher's current location address is 714 W Main St, Grass Valley, California. You can contact this provider via phone number 5304779800. The mailing address for Jessica Boucher is 714 W Main St, Grass Valley, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jessica Boucher |
|---|---|
| Address | 714 W Main St, Grass Valley, California |
| Phone Number | 5304779800 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1205042496 |
|---|---|
| Provider Enumeration Date | 2007-05-15 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 714 W Main St |
|---|---|
| City | Grass Valley |
| State | California (CA) |
| Post Code | 959456410 |
| Phone Number | 5304779800 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
|---|---|
| Taxonomy | 322D00000X |
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Definition: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. |
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What is the unique identifier code issued to Jessica Boucher by the Centers for Medicare & Medicaid Services?
The Jessica Boucher has been assigned the NPI (National Provider Identifier) 1205042496. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Jessica Boucher's facilities are situated?
The facilities of Jessica Boucher are physically located at the following address: 714 W Main St, Grass Valley, CA, 959456410.
What is the Jessica Boucher's specialty and taxonomy code?
The Jessica Boucher's specialty is Residential Treatment Facility, Emotionally Disturbed Children, and the corresponding taxonomy code is 322D00000X.
On what date did Jessica Boucher receive its 1205042496 assignment from the Centers for Medicare & Medicaid Services?
The Jessica Boucher was assigned its 1205042496 on 2007-05-15, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Jessica Boucher most recently updated or revised?
The information pertaining to Jessica Boucher, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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