EMERALD BLOSSOM MANOR, LLC.

SAN JOSE, CA
NPI1346714425
Entity TypeOrganization
Authorized ContactWAYNE VINCENT KILTHAU
Licensee
669-234-3344
Organization Subpart ?No
Primary Taxonomy315P00000X Intermediate Care Facility, Mentally Retarded
Enumeration Date2019-01-11
Last Update Date2019-01-11
Business Address
EMERALD BLOSSOM MANOR, LLC.
5301 GERINE BLOSSOM DR
SAN JOSE, CA 95123-2118
Phone number: 669-234-3344
Mailing Address
EMERALD BLOSSOM MANOR, LLC.
5301 GERINE BLOSSOM DR
SAN JOSE, CA 95123-2118
Phone number: 669-234-3344