NPI 1033397385
Main Ranch
Practice location
- Address
- 6526 Main Ave, Orangevale, CA 95662-4312
- Phone
- (916) 987-0822
- Fax
- (916) 988-5837
- Mailing address
- 7104 Santa Juanita Ave, Orangevale, CA 95662-2832
Authorised official
- Name
- Eduardo P Baltazar
- Title
- Administrator
- Phone
- (916) 293-1500
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1033397385
- Entity type
- Organization
- NPI issued
- 7 Feb 2008
- Record last updated
- 7 Feb 2008
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.