NPI 1578003711

The Parent Cooperative Community

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Fair Oaks, CA

Practice location

Address: 4426 Illinois Ave, Fair Oaks, CA 95628-6307
Phone: (916) 965-5135
Fax: (916) 947-0371

Authorised official

Name: Carla Derose
Title: Director
Phone: (916) 965-5135

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 347004337 (CA)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in California →

Registry record

NPI: 1578003711
Entity type: Organization
NPI issued: 7 Mar 2017
Record last updated: 7 Mar 2017

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.