Providence San Bruno Skilled Nursing Facility, Llc

NPI 1205213105 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1205213105
Enumeration Date 04/29/2015
Last Updated 03/02/2016
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name MARK MARK
Position CFO
Phone (650) 583-7768
Fax
Practice Location
890 EL CAMINO REAL
SAN BRUNO CA, 94066-3137, US
Phone (650) 583-7768
Fax
Business Location
890 EL CAMINO REAL
SAN BRUNO CA, 94066-3137, US
Phone (650) 583-7768
Fax
Toxanomy
Taxonomy Code 314000000X
License State
License Number
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According to our database, Providence San Bruno Skilled Nursing Facility, Llc NPI is 1205213105, taxonomy code is 314000000X Providence San Bruno Skilled Nursing Facility, Llc physically located at 890 El Camino Real, San Bruno CA, 94066-3137. NPI Number 1033115704 has the healthcare provider type.

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1205213105 NPI number is provided on an as is basis without warranty of any kind. 1205213105 is maintained by the National Plan & Provider Enumeration System. The contents of Providence San Bruno Skilled Nursing Facility, Llc are for informational purposes only.