# REIMS ICFDD H

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083817258
- **Authorized official:** MR. DOMINADOR D. PAJARITO (LICENSEE)
- **Authorized official phone:** (925) 383-4512

## Contact information

- **Practice address:** 22801 N SOWLES RD, ACAMPO, CA 95220-9608
- **Practice address phone:** (209) 366-2119
- **Practice address fax:** (209) 366-2119
- **Mailing address:** 22801 N SOWLES RD, ACAMPO, CA 95220-9608
- **Mailing address phone:** (209) 366-2119
- **Mailing address fax:** (209) 366-2119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | CA | Yes |

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 08/22/2020