Jerida Lane Residential Care
NPI #1154585883 in Fair Oaks, California
Provider Information
- NPI Number
- 1154585883
- Entity Type
- Organization
- Organization Name
- Jerida Lane Residential Care
- Primary Specialty
- Residential Treatment Facility, Physical Disabilities
- Enumeration Date
- Jul 11, 2008
- Last Updated
- Jul 11, 2008
Practice Location
- Address
- 8830 JERIDA LN
- City
- Fair Oaks
- State
- California
- ZIP Code
- 95628-5470
- Phone
- (916) 606-8241
Authorized Official
- Name
- MRS. ESTRELLITA DE MESA OLEA
- Title
- LICENSEE/ADMINISTRATOR
- Phone
- (916) 606-8241
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Physical Disabilities |
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