| NPI | 1053659086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSCAR ILUSORIO Vice President 408-205-5975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |