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Organization
KATHRYNE MANOR
Active
Organization
KATHRYNE MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA PALERACIO (LICENSEE)
(650) 245-2238
Entity
Organization
Contact information
Practice address
840 KATHRYNE AVE, SAN MATEO, CA 94401-3125
(650) 348-5393
Mailing address
840 KATHRYNE AVE, SAN MATEO, CA 94401-3125
(650) 348-5393
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
10/06/2007
Last updated
10/06/2007
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