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Rose Mendiola
Substance Abuse Rehabilitation Facility in Vallejo, California
NPI 1417324872

Rose Mendiola is a Substance Abuse Rehabilitation Facility based in Vallejo, CA. Rose Mendiola practices in Vallejo, CA. The NPI Number for Rose Mendiola is 1417324872 and holds a License No. R36801214 (California).

The current practice location address for Rose Mendiola is 130 Stanford Dr, Vallejo, CA and can be reached out via phone at 707-246-7971.

Location: 130 Stanford Dr, Vallejo, CA, 94589-1746
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417324872
Provider Name
Rose Mendiola
Credential
Provider Entity Type
Individual
Gender
Female
Address
130 Stanford Dr, Vallejo, CA, 94589-1746
Phone Number
707-246-7971
Fax Number
Provider Enumeration Date
09/01/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
C0600029 05 CA
institution
Provider Business Practice Location Address Details
Address
130 Stanford Dr
City
Vallejo
State
California
Zip
94589-1746
Phone Number
707-246-7971
Fax Number
person
Provider Business Mailing Address Details
Address
130 Stanford Dr
City
Vallejo
State
California
Zip
94589-1746
Phone Number
707-246-7971
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
R36801214 (California)
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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