# KATHRYNE MANOR

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

## Provider details

- **NPI number:** 1407044209
- **Authorized official:** ALICIA PALERACIO (LICENSEE)
- **Authorized official phone:** (650) 245-2238

## Contact information

- **Practice address:** 840 KATHRYNE AVE, SAN MATEO, CA 94401-3125
- **Practice address phone:** (650) 348-5393
- **Mailing address:** 840 KATHRYNE AVE, SAN MATEO, CA 94401-3125
- **Mailing address phone:** (650) 348-5393

## Taxonomy

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

## Other

- **Enumeration date:** 10/06/2007
- **Last updated:** 10/06/2007