# ELM RANCH 1 LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ELM RANCH 1
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609015783
- **Authorized official:** MR. EDUARDO P BALTAZAR RN (PRESIDENT)
- **Authorized official phone:** (916) 293-1500

## Contact information

- **Practice address:** 9048 ELM AVE, ORANGEVALE, CA 95662-3524
- **Practice address phone:** (916) 987-2954
- **Practice address fax:** (916) 987-1593
- **Mailing address:** 7104 SANTA JUANITA AVE, ORANGEVALE, CA 95662-2832
- **Mailing address phone:** (916) 293-1500
- **Mailing address fax:** (916) 987-1593

## Taxonomy

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

## Other

- **Enumeration date:** 02/12/2009
- **Last updated:** 02/12/2009