Healthcare Provider Details

I. General information

NPI: 1275797409
Provider Name (Legal Business Name): LTP GENERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 MACARTHUR BLVD
OAKLAND CA
94610-3233
US

IV. Provider business mailing address

PO BOX 1297
ALAMO CA
94507-7297
US

V. Phone/Fax

Practice location:
  • Phone: 510-836-3777
  • Fax: 510-836-0516
Mailing address:
  • Phone: 510-836-3777
  • Fax: 510-836-0516

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: MRS. LETICIA PANIS PEREZ
Title or Position: PRESIDENT
Credential: LVN
Phone: 925-837-7068