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Gary Green
Intellectual Disabilities Intermediate Care Facility in Chico, California
NPI 1316911886

Gary Green is a Intellectual Disabilities Intermediate Care Facility based in Redding, CA. Gary Green practices in Chico, CA. The NPI Number for Gary Green is 1316911886 and holds a License No. 230000277 (California).

The current practice location address for Gary Green is 65 Tom Polk Circle, Chico, CA and can be reached out via phone at 530-226-0375 and via fax at 530-365-1609.

Location: 65 Tom Polk Circle, Chico, CA, 96049
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316911886
Provider Name
Gary Green
Credential
Provider Entity Type
Organization
Address
65 Tom Polk Circle, Chico, CA, 96049
Phone Number
530-226-0375
Fax Number
530-365-1609
Provider Enumeration Date
02/14/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
LTC60788F 05 CA
institution
Provider Business Practice Location Address Details
Address
65 Tom Polk Circle
City
Chico
State
California
Zip
95973
Phone Number
530-226-0375
Fax Number
530-365-1609
person
Provider Business Mailing Address Details
Address
65 Tom Polk Circle
City
Chico
State
California
Zip
95973
Phone Number
530-226-0375
Fax Number
530-365-1609
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
230000277 (California)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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