Organization
FIVE SISTERS RANCH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCIE BROWN (DIRECTOR)
(954) 678-0078
Entity
Organization
Contact information
Practice address
1000 LONGHORN LN, PETALUMA, CA 94952-7808
(954) 678-0078
Mailing address
PO BOX 5037, PETALUMA, CA 94955-5037
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
490035AP
CA
324500000X
Substance Abuse Rehabilitation Facility
490035AP
CA
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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