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Tyson Home
Intellectual Disabilities Intermediate Care Facility in Vallejo, California
NPI 1699850016

Tyson Home is a Intellectual Disabilities Intermediate Care Facility based in Vallejo, CA. Tyson Home practices in Vallejo, CA. The NPI Number for Tyson Home is 1699850016 and holds a License No. (California).

The current practice location address for Tyson Home is 624 Mini Dr, Vallejo, CA and can be reached out via phone at 707-553-2798.

Location: 624 Mini Dr, Vallejo, CA, 94590-0142
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1699850016
Provider Name
Tyson Home
Credential
Provider Entity Type
Organization
Address
624 Mini Dr, Vallejo, CA, 94590-0142
Phone Number
707-553-2798
Fax Number
Provider Enumeration Date
10/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LTC60826F 05 CA
institution
Provider Business Practice Location Address Details
Address
624 Mini Dr
City
Vallejo
State
California
Zip
94589-1735
Phone Number
707-553-2798
Fax Number
person
Provider Business Mailing Address Details
Address
624 Mini Dr
City
Vallejo
State
California
Zip
94589-1735
Phone Number
707-553-2798
Fax Number
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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