Organization
SANTA LUCIA II ICF DDH INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEONILA PADILLA (OWNER)
(707) 655-3225
Entity
Organization
Contact information
Practice address
722 LASSEN ST, VALLEJO, CA 94591-5467
(707) 655-3225
Mailing address
722 LASSEN ST, VALLEJO, CA 94591-5467
(707) 655-3225
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
550001496
CA
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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