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Organization
SENIOR SUPPORT PROGRAM OF THE TRI VALLEY
Active
Organization
SENIOR SUPPORT PROGRAM OF THE TRI VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLENE J PETERSEN (EXECUTIVE DIRECTOR)
(925) 931-5378
Entity
Organization
Contact information
Practice address
5353 SUNOL BLVD, PLEASANTON, CA 94566-7607
(925) 931-5379
Mailing address
5353 SUNOL BLVD, PLEASANTON, CA 94566-7607
(925) 931-5379
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
2758503
CA
251S00000X
Community/Behavioral Health Agency
Primary
2758503
CA
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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