# JERIDA LANE RESIDENTIAL CARE

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

## Provider details

- **NPI number:** 1154585883
- **Authorized official:** MRS. ESTRELLITA DE MESA OLEA (LICENSEE/ADMINISTRATOR)
- **Authorized official phone:** (916) 606-8241

## Contact information

- **Practice address:** 8830 JERIDA LN, FAIR OAKS, CA 95628-5470
- **Practice address phone:** (916) 606-8241
- **Practice address fax:** (916) 863-0668
- **Mailing address:** 8830 JERIDA LN, FAIR OAKS, CA 95628-5470
- **Mailing address phone:** (916) 606-8241
- **Mailing address fax:** (916) 863-0668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | 347003312 | CA | Yes |

## Other

- **Enumeration date:** 07/11/2008
- **Last updated:** 07/11/2008