# THE PARENT COOPERATIVE COMMUNITY

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

## Provider details

- **NPI number:** 1578003711
- **Authorized official:** MS. CARLA DEROSE MA, MFT (DIRECTOR)
- **Authorized official phone:** (916) 965-5135

## Contact information

- **Practice address:** 4426 ILLINOIS AVE, FAIR OAKS, CA 95628-6307
- **Practice address phone:** (916) 965-5135
- **Practice address fax:** (916) 947-0371
- **Mailing address:** 4426 ILLINOIS AVE, FAIR OAKS, CA 95628-6307
- **Mailing address phone:** (916) 965-5135
- **Mailing address fax:** (916) 947-0371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 347004337 | CA | Yes |

## Other

- **Enumeration date:** 03/07/2017
- **Last updated:** 03/07/2017