1790951580 NPI number — A & C HEALTH CARE SERVICES

Table of content: (NPI 1790951580)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790951580 NPI number — A & C HEALTH CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A & C HEALTH CARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MILLBRAE MANOR RESIDENTIAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790951580
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5615 COTTLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95123-3625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-226-0300
Provider Business Mailing Address Fax Number:
408-226-3800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 HEMLOCK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLBRAE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94030-2046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-588-1000
Provider Business Practice Location Address Fax Number:
650-588-1589
Provider Enumeration Date:
05/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RAGUDO
Authorized Official First Name:
AMPARO
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
C.F.O.
Authorized Official Telephone Number:
408-226-0300

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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