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Santa Lucia Icf-ddh
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Vallejo, California
NPI 1871774125

Santa Lucia Icf-ddh is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Vallejo, CA. Santa Lucia Icf-ddh practices in Vallejo, CA. The NPI Number for Santa Lucia Icf-ddh is 1871774125 and holds a License No. (California).

The current practice location address for Santa Lucia Icf-ddh is 11 Marshall Way, Vallejo, CA and can be reached out via phone at 707-731-2747 and via fax at 707-731-2748.

Location: 11 Marshall Way, Vallejo, CA, 94589-1946
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1871774125
Provider Name
Santa Lucia Icf-ddh
Credential
Provider Entity Type
Organization
Address
11 Marshall Way, Vallejo, CA, 94589-1946
Phone Number
707-731-2747
Fax Number
707-731-2748
Provider Enumeration Date
11/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LTC61065F 01 CA MEDICAL PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
11 Marshall Way
City
Vallejo
State
California
Zip
94589-1946
Phone Number
707-731-2747
Fax Number
707-731-2748
person
Provider Business Mailing Address Details
Address
11 Marshall Way
City
Vallejo
State
California
Zip
94589-1946
Phone Number
707-731-2747
Fax Number
707-731-2748
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
(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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