Organization
ELM RANCH 1 LLC
Active
Other names
ELM RANCH 1
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDUARDO P BALTAZAR RN (PRESIDENT)
(916) 293-1500
Entity
Organization
Contact information
Practice address
9048 ELM AVE, ORANGEVALE, CA 95662-3524
(916) 987-2954
(916) 987-1593
Mailing address
7104 SANTA JUANITA AVE, ORANGEVALE, CA 95662-2832
(916) 293-1500
(916) 987-1593
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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