Organization
GREENFIELDS ICF-DDN
Active
Parent organization
GREENFIELDS ICF-DDN
Other names
Greenfields II
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREENFIELDS ICF-DDN
Authorized official
TERESITA REYES RN (ADMINISTRATOR)
(707) 553-2935
Entity
Organization
Contact information
Practice address
2673 VISTA BONITA, FAIRFIELD, CA 94534-1729
(707) 553-2935
(707) 552-1267
Mailing address
400 SANTA CLARA ST, SUITE 200, VALLEJO, CA 94590-5983
(707) 553-2935
(707) 552-1267
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
010000345
CA
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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