| Organization Name: | OBDULIA'S RESTHOME, INC |
| NPI Number: | 1366637357 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROSE CAREY (LICENSEE/ADMINISTRATOR) |
| Mailing Address: | 2335 Silver Ave 1919 Palou Ave San Francisco |
| State: | CA US |
| Postal Code: | 941242060 |
| Phone Number: | 4156414171 |
| Fax Number: | 4158210720 |
| NPI Enumeration Date: | 09/12/2007 |
| NPI Last Update Date: | 09/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320800000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |