Healthcare Provider Details

I. General information

NPI: 1629145610
Provider Name (Legal Business Name): HEBREW HOME FOR THE AGED DISABLED DBA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 SILVER AVE
SAN FRANCISCO CA
94112
US

IV. Provider business mailing address

302 SILVER AVE
SAN FRANCISCO CA
94112
US

V. Phone/Fax

Practice location:
  • Phone: 415-469-2262
  • Fax: 415-333-4345
Mailing address:
  • Phone: 415-469-2262
  • Fax: 415-333-4345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number220000224
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number220000224
License Number StateCA

VIII. Authorized Official

Name: KEVIN EMLET
Title or Position: CFO
Credential:
Phone: 415-846-0431