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TYSON HOME

Intermediate Care Facility, Mentally Retarded

Vallejo, California

Provider NPI: 1699850016

Organization Information:
Organization Name:  TYSON HOME


Practice Location:
624 MINI DR  VALLEJO, CA 94589 US
Tel: 707-553-2798  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
CA

Other Provider Identifiers:

IssuerNumberStateType
LTC60826FCA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS CA - Page 1



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