| NPI | 1073816765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DAMON FRACH Office Manager 408-984-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse Registered Nurse First Assistant |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2010-12-18 |
| Last Update Date | 2010-12-18 |