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

## Provider details

- **NPI number:** 1306971932
- **Authorized official:** MRS. AMELIA SANCHEZ TORRES (ADMINISTRATOR)
- **Authorized official phone:** (510) 245-2948

## Contact information

- **Practice address:** 295 SPARROW DR, HERCULES, CA 94547-1507
- **Practice address phone:** (510) 245-2948
- **Practice address fax:** (510) 245-2948
- **Mailing address:** 295 SPARROW DR, HERCULES, CA 94547-1507
- **Mailing address phone:** (510) 245-2948
- **Mailing address fax:** (510) 245-2948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | 075601206 | CA | Yes |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 07/10/2008