Organization
NIC USA INC
Active
Other names
Happy Valley ICFDDH 2
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COSTIN NICULESCU (EXECUTIVE DIRECTOR)
(925) 944-1222
Entity
Organization
Contact information
Practice address
2478 WARREN LN, WALNUT CREEK, CA 94597
(925) 944-1222
(925) 946-9254
Mailing address
2478 WARREN LN, WALNUT CREEK, CA 94597
(925) 944-1222
(925) 946-9254
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60627F
—
CA
Enumeration date
02/21/2007
Last updated
08/22/2020
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