person
Kyle Addison
Emotionally Disturbed Childrens' Residential Treatment Facility in San Jose, California
NPI 1700101540

Kyle Addison is a Emotionally Disturbed Childrens' Residential Treatment Facility based in San Jose, CA. Kyle Addison practices in San Jose, CA. The NPI Number for Kyle Addison is 1700101540 and holds a License No. 3649 (California).

The current practice location address for Kyle Addison is 6630 Marymonte Ct, San Jose, CA and can be reached out via phone at 408-205-8996. You can also correspond with Kyle Addison through the mailing address at 1058 S 5TH ST, SAN JOSE, CA - 95112-6702 (mailing address contact number: 510-673-2285).

Location: 6630 Marymonte Ct, San Jose, CA, 95112-6702
person
Provider Profile Details
NPI Number
1700101540
Provider Name
Kyle Addison
Credential
Provider Entity Type
Individual
Gender
Male
Address
6630 Marymonte Ct, San Jose, CA, 95112-6702
Phone Number
408-205-8996
Fax Number
Provider Enumeration Date
04/05/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6630 Marymonte Ct
City
State
Zip
95120-4517
Phone Number
408-205-8996
Fax Number
person
Provider Business Mailing Address Details
Address
6630 Marymonte Ct
City
State
Zip
95120-4517
Phone Number
408-205-8996
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
License No.
3649 (California)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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