Organization
PRELUDE 2 INDEPENDENT LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN COREY RINGGOLD (EXECUTIVE DIRECTOR)
(877) 480-9373
Entity
Organization
Contact information
Practice address
5800 JAMESON CT, SUITE #7, CARMICHAEL, CA 95608-0880
(877) 480-9373
(916) 650-1105
Mailing address
5800 JAMESON CT, SUITE #7, CARMICHAEL, CA 95608-0880
(877) 480-9373
(916) 650-1105
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
330201
CA
251C00000X
Developmentally Disabled Services Day Training Agency
330201
CA
251S00000X
Community/Behavioral Health Agency
330201
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225277064
—
CA
Enumeration date
06/25/2009
Last updated
06/25/2009
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