| Odd-fellow Rebekah Children's Home Of Ca | |
|
5000 Lyng Dr San Jose CA 95111-2720 | |
| (408) 846-2100 | |
| Not Available |
| Full Name | Odd-fellow Rebekah Children's Home Of Ca |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5000 Lyng Dr, San Jose, California |
| Authorized Official Name and Position | Jennifer Dang Malone (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 4088462141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Odd-fellow Rebekah Children's Home Of Ca 290 Ioof Ave Gilroy CA 95020-5204 Ph: (408) 846-2141 | Odd-fellow Rebekah Children's Home Of Ca 5000 Lyng Dr San Jose CA 95111-2720 Ph: (408) 846-2100 |
| NPI Number | 1700518933 |
|---|---|
| Provider Enumeration Date | 06/27/2022 |
| Last Update Date | 06/27/2022 |
| Certification Date | 06/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700518933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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