Healthcare Provider Details

I. General information

NPI: 1629476239
Provider Name (Legal Business Name): JC CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2014
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 CALIFORNIA ST
SAN FRANCISCO CA
94115-2514
US

IV. Provider business mailing address

2740 CALIFORNIA ST
SAN FRANCISCO CA
94115-2514
US

V. Phone/Fax

Practice location:
  • Phone: 415-567-3133
  • Fax: 415-567-3037
Mailing address:
  • Phone: 415-567-3133
  • Fax: 415-567-3037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2200000109
License Number StateCA

VIII. Authorized Official

Name: JOHN CHALICH
Title or Position: PRESIDENT
Credential:
Phone: 415-567-3133