Organization
MAIN RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDUARDO P BALTAZAR (ADMINISTRATOR)
(916) 293-1500
Entity
Organization
Contact information
Practice address
6526 MAIN AVE, ORANGEVALE, CA 95662-4312
(916) 987-0822
(916) 988-5837
Mailing address
7104 SANTA JUANITA AVE, ORANGEVALE, CA 95662-2832
(916) 293-1500
(916) 988-5837
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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