IndividualActive
Benjamin Moller
NPI 1609182682 · Emotionally Disturbed Childrens' Residential Treatment Facility · Grass Valley, CA
Provider details
- NPI number
- 1609182682
- Entity type
- Individual
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
714 W Main St
Grass Valley, CA 95945-6410
Phone: (530) 477-9800
Fax: (530) 477-9803
Approximate (ZIP-level) locationGet directions
Mailing address
714 W Main St
Grass Valley, CA 95945-6410
Registry dates
- Enumerated
- 2010-08-27
- Last updated
- 2010-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.