Organization
MARTIN'S ACHEIVEMENT PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH L BROUGHTON (ASSISTANT HOUSE MANAGER)
(916) 202-1417
Entity
Organization
Contact information
Practice address
5240 JACKSON ST, NORTH HIGHLANDS, CA 95660-5003
(916) 338-1001
Mailing address
PO BOX 560, CITRUS HEIGHTS, CA 95611-0560
(916) 338-1001
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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