# SANTA LUCIA II ICF-DDH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952617870
- **Authorized official:** MRS. LEONILA REALEZA PADILLA (ADMINISTRATOR)
- **Authorized official phone:** (707) 655-3225

## Contact information

- **Practice address:** 722 LASSEN ST, VALLEJO, CA 94591-5467
- **Practice address phone:** (707) 554-1975
- **Practice address fax:** (707) 648-1549
- **Mailing address:** 722 LASSEN ST, VALLEJO, CA 94591-5467
- **Mailing address phone:** (707) 554-1975
- **Mailing address fax:** (707) 648-1549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310500000X | Mental Illness Intermediate Care Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/30/2010
- **Last updated:** 08/30/2010