Organization
CCI, INC.
Active
Other names
Stanley House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL JAMES FISHER M.ED. (PRESIDENT)
(925) 560-0124
Entity
Organization
Contact information
Practice address
7874 DIANA LN, DUBLIN, CA 94568-1615
(925) 479-9023
(925) 560-0125
Mailing address
PO BOX 112, ALAMO, CA 94507-0112
(925) 560-0124
(925) 560-0125
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
LTC60300F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60300F
—
CA
Enumeration date
02/12/2007
Last updated
08/22/2020
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