Provider First Line Business Practice Location Address:
230 NO MORRISON AVE
Provider Second Line Business Practice Location Address:
SUB ACUTE RESIDENTIAL TREATMENT SART
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95126-2741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-938-8516
Provider Business Practice Location Address Fax Number:
408-295-4231
Provider Enumeration Date:
02/21/2007