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Organization
THE ARC OF SAN DIEGO
Active
Organization
THE ARC OF SAN DIEGO
Active
Other names
Potter Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH TONTODONATO (DIRECTOR OF OPERATIONS)
(619) 685-1175
Entity
Organization
Contact information
Practice address
2930 HELIX STREET, SPRING VALLEY, CA 91977
(619) 685-1175
(619) 234-3759
Mailing address
3030 MARKET STREET, SAN DIEGO, CA 92102
(619) 685-1175
(619) 906-4031
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05-G076
—
CA
Enumeration date
12/04/2007
Last updated
07/27/2016
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