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Organization
GENERAL ASSEMBLY OF THE CHRISTIAN CHURCH
Active
Organization
GENERAL ASSEMBLY OF THE CHRISTIAN CHURCH
Active
Other names
NBA SERRA CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ANN C STAFFORD (CHIEF FINANCIAL OFFICER)
(573) 876-7302
Entity
Organization
Contact information
Practice address
4066 BONDE WAY, FREMONT, CA 94536-4801
(610) 608-3900
(510) 608-3914
Mailing address
4066 BONDE WAY, FREMONT, CA 94536-4801
(610) 608-3900
(510) 608-3914
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
020000402
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60517F
—
CA
Enumeration date
01/29/2007
Last updated
07/11/2008
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