| NPI | 1104464163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH MARTINEZ-DAVIS Manager 650-466-6899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2019-12-20 |