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Organization

GREENFIELDS INTERMEDIATE CARE FACILITY

Active
Other names
GREENFIELDS IV ICF-DDN
Organization subpart
No

Provider details

NPI number
Authorized official
TERESITA CABAB REYES RN (RN ADMINISTRATOR)
(707) 553-2935
Entity
Organization

Contact information

Practice address
101 HAWKESBURY WAY, VALLEJO, CA 94591-4337
(707) 553-2935
(707) 553-2993
Mailing address
101 HAWKESBURY WAY, VALLEJO, CA 94591-4337
(707) 553-2935
(707) 553-2993

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
550000659
CA

Other

Enumeration date
06/30/2008
Last updated
06/30/2008
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