Organization
SANTA LUCIA II ICF-DDH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEONILA REALEZA PADILLA (ADMINISTRATOR)
(707) 655-3225
Entity
Organization
Contact information
Practice address
722 LASSEN ST, VALLEJO, CA 94591-5467
(707) 554-1975
(707) 648-1549
Mailing address
722 LASSEN ST, VALLEJO, CA 94591-5467
(707) 554-1975
(707) 648-1549
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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