| NPI | 1811182942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY C MATEO LLC Officer 415-587-6034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: CA 380540235) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: CA 380540234) |
| 311ZA0620X Custodial Care Facility Adult Care Home (Licence: CA 389210033) | |
| 311ZA0620X Custodial Care Facility Adult Care Home (Licence: CA 389210032) | |
| 311ZA0620X Custodial Care Facility Adult Care Home (Licence: CA 385600364) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2008-07-23 |