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Paradise Valley Icf-ddh
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fairfield, California
NPI 1730360082

Paradise Valley Icf-ddh is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Fairfield, CA. Paradise Valley Icf-ddh practices in Fairfield, CA. The NPI Number for Paradise Valley Icf-ddh is 1730360082 and holds a License No. 010000432 (California).

The current practice location address for Paradise Valley Icf-ddh is 3313 El Pinole Way, Fairfield, CA and can be reached out via phone at 707-425-2202 and via fax at 707-425-6060.

Location: 3313 El Pinole Way, Fairfield, CA, 94533-7208
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1730360082
Provider Name
Paradise Valley Icf-ddh
Credential
Provider Entity Type
Organization
Address
3313 El Pinole Way, Fairfield, CA, 94533-7208
Phone Number
707-425-2202
Fax Number
707-425-6060
Provider Enumeration Date
11/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LTC61010F 01 CA MEDICAL PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
3313 El Pinole Way
City
Fairfield
State
California
Zip
94533-7208
Phone Number
707-425-2202
Fax Number
707-425-6060
person
Provider Business Mailing Address Details
Address
3313 El Pinole Way
City
Fairfield
State
California
Zip
94533-7208
Phone Number
707-425-2202
Fax Number
707-425-6060
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
010000432 (California)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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