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General NPI Number Information
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NPI Number | 1760653091
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Entity Type | Organization
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Legal Business Name | RIVER OAK CENTER FOR CHILDREN
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 5030 EL CAMINO AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-4650
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Country | US
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Telephone | 916-609-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 5030 EL CAMINO AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-4650
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SKILLS TRAINER
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Name | MS. THEODRY GALLAREAD
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Credential |
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Telephone | 916-609-4967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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