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Bennett Valley Icf Ddh Inc
Intellectual Disabilities Intermediate Care Facility in Santa Rosa, California
NPI 1326198524

Bennett Valley Icf Ddh Inc is a Intellectual Disabilities Intermediate Care Facility based in San Bruno, CA. Bennett Valley Icf Ddh Inc practices in Santa Rosa, CA. The NPI Number for Bennett Valley Icf Ddh Inc is 1326198524 and holds a License No. (California).

The current practice location address for Bennett Valley Icf Ddh Inc is 2416 Cactus Avenue, Santa Rosa, CA and can be reached out via phone at 707-544-6465 and via fax at 650-347-8887.

Location: 2416 Cactus Avenue, Santa Rosa, CA, 94066
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1326198524
Provider Name
Bennett Valley Icf Ddh Inc
Credential
Provider Entity Type
Organization
Address
2416 Cactus Avenue, Santa Rosa, CA, 94066
Phone Number
707-544-6465
Fax Number
650-347-8887
Provider Enumeration Date
01/11/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
55 G072 01 CA MEDICAL
institution
Provider Business Practice Location Address Details
Address
2416 Cactus Avenue
City
Santa Rosa
State
California
Zip
95405
Phone Number
707-544-6465
Fax Number
650-347-8887
person
Provider Business Mailing Address Details
Address
2416 Cactus Avenue
City
Santa Rosa
State
California
Zip
95405
Phone Number
707-544-6465
Fax Number
650-347-8887
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
(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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