Organization
WOODLAND RESIDENTIAL SERVICES, INC.
Active
Other names
Squaw Program
Organization subpart
No
Provider details
NPI number
Authorized official
PARMINDER KAJLEY (ADMINISTRATOR)
(530) 406-0333
Entity
Organization
Contact information
Practice address
1571 SQUAW VALLEY DR, WOODLAND, CA 95776-6740
(530) 406-0333
Mailing address
1381 E GUM AVE, WOODLAND, CA 95776-4275
(530) 406-0333
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
100000520
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100000520
DHS LICENSE NUMBER
CA
Enumeration date
05/21/2007
Last updated
12/19/2011
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