Organization
VALLONE TRISTAN CIRCLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GODWIN AKA (CEO)
(916) 225-0349
Entity
Organization
Contact information
Practice address
96 TRISTAN CIR, SACRAMENTO, CA 95823-4145
(916) 392-1968
Mailing address
PO BOX 2944, MERCED, CA 95344-0944
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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