Healthcare Provider Details

I. General information

NPI: 1508798810
Provider Name (Legal Business Name): MONTGOMERY CARE SENIOR CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 GROVE WAY
CASTRO VALLEY CA
94546-6955
US

IV. Provider business mailing address

1925 GROVE WAY
CASTRO VALLEY CA
94546-6955
US

V. Phone/Fax

Practice location:
  • Phone: 510-889-8556
  • Fax: 510-876-8929
Mailing address:
  • Phone: 510-889-8556
  • Fax: 510-876-8929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MIRRIAM T PARAS
Title or Position: ADMINISTRATOR
Credential: BUSINESS ACCOUNTING
Phone: 415-726-7817