NPI 1114679305
Fair Oaks Residential Treatment Facility, LLC
Practice location
- Address
- 1782 B St, Hayward, CA 94541-3102
- Phone
- (916) 458-4100
- Mailing address
- 2880 Zanker Rd STE 106, San Jose, CA 95134-2121
Authorised official
- Name
- Alex Rudakov
- Title
- Secretary
- Phone
- (415) 812-2955
Registered specialties
Nursing Care Agency
Primary
Registry record
- NPI
- 1114679305
- Entity type
- Organization
- NPI issued
- 19 Jan 2022
- Record last updated
- 19 Jan 2022
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.