# PEEBLES FAMILY CARE HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PALS Assisted Living Services Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578749149
- **Authorized official:** MS. NAWANA MIESA GRAY (ADMINISTRATOR CEO)
- **Authorized official phone:** (209) 298-0849

## Contact information

- **Practice address:** 404 NORTH BROADWAY AVE, STOCKTON, CA 95205
- **Practice address phone:** (209) 464-3024
- **Practice address fax:** (209) 944-5659
- **Mailing address:** 404 NORTH BROADWAY AVE, STOCKTON, CA 95205
- **Mailing address phone:** (209) 464-3024
- **Mailing address fax:** (209) 944-5659

## Taxonomy

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

## Other

- **Enumeration date:** 01/14/2008
- **Last updated:** 01/14/2008