Healthcare Provider Details

I. General information

NPI: 1720119795
Provider Name (Legal Business Name): SOUTH VALLEY CARE HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5810 OBATA WAY STE 1 SUITE 1
GILROY CA
95020-7039
US

IV. Provider business mailing address

5810 OBATA WAY SUITE 1
GILROY CA
95020-7039
US

V. Phone/Fax

Practice location:
  • Phone: 408-847-9738
  • Fax: 408-847-9743
Mailing address:
  • Phone: 408-847-9738
  • Fax: 408-847-9743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. BRIAN S ADAMS
Title or Position: OWNER
Credential:
Phone: 408-592-1834