Organization
JERIDA LANE RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTRELLITA DE MESA OLEA (LICENSEE/ADMINISTRATOR)
(916) 606-8241
Entity
Organization
Contact information
Practice address
8830 JERIDA LN, FAIR OAKS, CA 95628-5470
(916) 606-8241
(916) 863-0668
Mailing address
8830 JERIDA LN, FAIR OAKS, CA 95628-5470
(916) 606-8241
(916) 863-0668
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
347003312
CA
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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