Healthcare Provider Details

I. General information

NPI: 1205151644
Provider Name (Legal Business Name): RUUS MANOR INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29255 RUUS RD
HAYWARD CA
94544-6334
US

IV. Provider business mailing address

PO BOX 1254
MILLBRAE CA
94030-5254
US

V. Phone/Fax

Practice location:
  • Phone: 650-580-0753
  • Fax: 650-873-6924
Mailing address:
  • Phone: 510-785-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number020000419
License Number StateCA

VIII. Authorized Official

Name: MR. REY B. RAMIREZ
Title or Position: CEO
Credential:
Phone: 510-785-9933