Healthcare Provider Details

I. General information

NPI: 1669675096
Provider Name (Legal Business Name): THE GEORGE G. GLENNER ALZHEIMER'S FAMILY CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 SAXONY ROAD
ENCINITAS CA
92024
US

IV. Provider business mailing address

2765 MAIN STREET, SUITE A
CHULA VISTA CA
91911
US

V. Phone/Fax

Practice location:
  • Phone: 760-635-1895
  • Fax: 760-436-0949
Mailing address:
  • Phone: 619-543-4700
  • Fax: 619-295-1057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT J TARDE
Title or Position: CHIEF EXECUTIVE OFFICER/EXECUTIVE D
Credential: LNHA
Phone: 619-543-4700