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General NPI Number Information
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NPI Number | 1487169413
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Entity Type | Organization
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Legal Business Name | SENECA FAMILY OF AGENCIES
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 365 KUCK LN
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City | PETALUMA
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State | CA
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Zip | 94952-9606
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Country | US
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Telephone | 510-317-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 2275 ARLINGTON DR
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City | SAN LEANDRO
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State | CA
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Zip | 94578-1132
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Country | US
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Telephone | 510-317-1444
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Fax |
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Authorized Official
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Title or Position | QUALITY ASSURANCE DIRECTOR
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Name | SANDY HOBSON
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Credential |
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Telephone | 510-725-5727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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