Provider First Line Business Practice Location Address:
1421 BRODERICK STREET
Provider Second Line Business Practice Location Address:
BRODERICK ADULT RESIDENTIAL FACILITY
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-292-1760
Provider Business Practice Location Address Fax Number:
415-292-2511
Provider Enumeration Date:
02/27/2007