Brian J Carrillo

NPI 1245590678 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1245590678
Gender Male
Enumeration Date 05/18/2012
Last Updated 05/18/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
714 W MAIN ST
GRASS VALLEY CA, 95945-6410, US
Phone (530) 477-9800
Fax (530) 477-9803
Business Location
714 W MAIN ST
GRASS VALLEY CA, 95945-6410, US
Phone (530) 477-9800
Fax (530) 477-9803
Toxanomy
Taxonomy Code 322D00000X
License State
License Number
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According to our database, Brian J Carrillo NPI is 1245590678, taxonomy code is 322D00000X Brian J Carrillo physically located at 714 W Main St, Grass Valley CA, 95945-6410. NPI Number Brian J Carrillo has the Individual type.

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1245590678 NPI number is provided on an as is basis without warranty of any kind. 1245590678 is maintained by the National Plan & Provider Enumeration System. The contents of Brian J Carrillo are for informational purposes only.