Healthcare Provider Details
I. General information
NPI: 1083869366
Provider Name (Legal Business Name): YOLO COUNTY CARE CONTIUNNM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/01/2008
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5730 KANDINSKY WAY
SACRAMENTO CA
95835-2331
US
IV. Provider business mailing address
5730 KANDINSKY WAY
SACRAMENTO CA
95835-2331
US
V. Phone/Fax
- Phone: 916-419-2674
- Fax:
- Phone: 916-419-2674
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
INDERJEET
KAUR
Title or Position: MENTAL HEALTH WORKER
Credential:
Phone: 916-335-9619