Organization
MARINE RESIDENTIAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIEBETH B ARZADON (LICENSEE)
(916) 647-3250
Entity
Organization
Contact information
Practice address
9649 SEA CLIFF WAY, ELK GROVE, CA 95758-7131
(916) 647-3250
(916) 359-5182
Mailing address
9649 SEA CLIFF WAY, ELK GROVE, CA 95758-7131
(916) 647-3250
(916) 359-5182
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
347003529
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T1020
—
CA
Enumeration date
02/09/2012
Last updated
02/09/2012
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