Healthcare Provider Details

I. General information

NPI: 1265765556
Provider Name (Legal Business Name): ALGT,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2009
Last Update Date: 05/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14966 TERRENO DE FLORES LN
LOS GATOS CA
95032-2023
US

IV. Provider business mailing address

28202 CABOT RD 412
LAGUNA NIGUEL CA
92677-1222
US

V. Phone/Fax

Practice location:
  • Phone: 949-347-7100
  • Fax: 949-347-7800
Mailing address:
  • Phone: 949-347-7100
  • Fax: 949-347-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY JARED BRADSHAW
Title or Position: SECRETARY/VP OPERATIONS
Credential:
Phone: 714-548-8046