Healthcare Provider Details

I. General information

NPI: 1386678340
Provider Name (Legal Business Name): TOGETHER WE GROW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 MISSION AVE STE 107
OCEANSIDE CA
92054-1815
US

IV. Provider business mailing address

5055 VIEWRIDGE AVE
SAN DIEGO CA
92123-4313
US

V. Phone/Fax

Practice location:
  • Phone: 760-757-6031
  • Fax: 760-757-4813
Mailing address:
  • Phone: 858-751-0209
  • Fax: 858-751-0204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: TERRY JANE RACCIATO
Title or Position: PRESIDENT
Credential: RN
Phone: 858-751-0209