Organization
NORTHERN CALIFORNIA ADAPTIVE LIVING CENTER, INC.
Active
Other names
Lakeview Facility
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN C KOLAR (EXECUTIVE DIRECTOR)
(530) 894-2726
Entity
Organization
Contact information
Practice address
1116 W PERKINS ST, UKIAH, CA 95482-4625
(707) 468-0602
(707) 468-3854
Mailing address
3028 ESPLANADE, SUITE H, CHICO, CA 95973-4924
(530) 894-2726
(530) 894-2798
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60260G
MEDI-CAL
CA
Enumeration date
05/16/2007
Last updated
08/22/2020
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