Organization
DAVIDSON ADULT HOME /SUN VALLEY CT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE DIANE DAVIDSON RN (OWNER)
(209) 384-7402
Entity
Organization
Contact information
Practice address
48 SUN VALLEY CT, MERCED, CA 95348-3017
(209) 384-7402
(209) 383-1538
Mailing address
PO BOX 332, MERCED, CA 95341-0332
(209) 384-7402
(209) 383-1538
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
LTC70715F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60772F
—
CA
Enumeration date
09/26/2007
Last updated
09/26/2007
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