Individual
NICK ROBERT PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24321 COUNTY ROAD 96, DAVIS, CA 95616
(530) 758-1653
Mailing address
1667 OAK AVE, DAVIS, CA 95616-1003
(530) 758-2160
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/30/2007
Last updated
12/13/2010
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