Organization
PRESIDENT JOHN ADAMS MANOR III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WORTHEN (CFO)
(916) 417-3481
Entity
Organization
Contact information
Practice address
5701 FALCONER WAY, SACRAMENTO, CA 95824-1517
(916) 417-3481
(916) 927-4370
Mailing address
5701 FALCONER WAY, SACRAMENTO, CA 95824-1517
(916) 417-3481
(916) 927-4370
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60643F
—
CA
Enumeration date
04/18/2007
Last updated
08/22/2020
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