| NPI | 1285458653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA MELENDEZ Manager 510-367-5179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2025-02-05 |