| NPI | 1912163031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEEBE TUPAZ Owner 408-377-1622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2009-04-10 |