| NPI | 1518178904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEEBE TUPAZ Owner 408-377-1622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: CA LTC60391G) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2009-04-10 |