Organization
ANTELOPE HILLS MANOR ICF/DD-N INC.
Active
Parent organization
ANTELOPE HILLS MANOR ICF/DD-N INC.
Other names
Tullia PLace ICF/DD-N
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANTELOPE HILLS MANOR ICF/DD-N INC.
Authorized official
MR. ANTONIO G RANIT RN (ADMINISTRATOR)
(916) 548-1397
Entity
Organization
Contact information
Practice address
8533 TULLIA PL, ANTELOPE, CA 95843-5986
(916) 548-1397
(916) 721-9439
Mailing address
9500 LITTORAL ST, ROSEVILLE, CA 95747-9168
(916) 548-1397
(916) 721-9439
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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